Abstract
The effect of obstructive jaundice on the distribution and elimination of propofol was studied in 15 patients with obstructive jaundice (total serum bilirubin, TBL 17.1μmol.l ) and in 15 control patients (TBL < 17.1μmol.l ). Following an i.v. bolus dose of propofol (2-2.5 mg.kg ) multiple arterial samples were obtained at timed intervals for 4 h and blood concentrations of propofol were measured by high pressure liquid chromatography. Compartmental analysis of propofol concentrations revealed a three-compartment model with elimination from a central compartment in all patients. Pharmacokinelic parameters: volumes of distribution at steady state (V ), volumes of distribution at equilibrium (Vr), volumes of the central compartment (V) and total body clearance (Cl) were similar in patients with obstructive jaundice (mean 12.3 (SD 6.0) litre.kg , 32.99(21.42 ) litre.kg-1, 0.241(0.131) litre.kg-1, and 28.8(8.2) ml.min-1.kg respectively) compared with contro1 group (11.9 (5.4) litre.kg , 28.30(13.70) litre.kg-1, 0.297(0.112) litre.kg-1, and 33.9(7.6) ml.min-1.kg respectively) (P > 0.05). Half-times of the three phases ( T1/2 ,T1/2 ,T1/2 ) were also similar between both groups.We conclude that in patients with obstructive jaundice the pharmacokinetics of propofol are similar to those of patients without obstructive jaundice.
Keywords: Anaesthetics i.v., propofol, pharmacokinetics, liver-bile