PHARMACOKINETICS OF PROPOFOL AND HEMODYNAMIC-CHANGES DURING INDUCTION OF ANESTHESIA IN UREMIC PATIENTS

The pharmacokinetics of an i.v. bolus of propofol 2 mg kg-1 were studied in 10 uraemic patients undergoing renal transplantation and in seven healthy controls matched for age, weight and duration of anaesthesia. Hemodynamic changes during induction of anaesthesia were recorded in the uraemic and in 10 healthy control patients. Pharmacokinetic variables were similar in uraemic and control patients; mean elimination half-lives were 1638 (SD 340) min and 1714 (842) min, respectively. Induction of anaesthesia with propofol was preceded by fentanyl 3-mu-g kg-1. After administration of propofol over 60 s, systolic arterial pressure decreased by 19 (12) %, and by 24 (11) % in the adequately volume loaded uraemic and healthy patients, respectively. Propofol caused a marked peripheral vasodilatation in all patients. A moderate increase in systolic arterial pressure after intubation was statistically significant only in the control patients (P < 0.01). We conclude that, in terms of pharmacokinetics and haemodynamic changes, propofol may be used safely for the induction of general anaesthesia in uraemic patients.