Cardiovascular effects of a single dose of propofol in coronary patients with good ventricular function

OBJECTIVES: To determine the cardiovascular effects of a single dose of propofol in coronary patients with good ventricular function. PATIENTS AND METHODS: Propofol 2 mg/kg-1 was administered to twenty coronary patients during dissection of the internal mammary artery in myocardial revascularization surgery. Heart rate (HR), systolic and diastolic systemic and pulmonary arterial pressure (SAP, DAP, SPAP and DPAP), central venous pressure, pulmonary capillary wedge pressure, cardiac output (CO), right ventricular ejection fraction, systemic and pulmonary vascular resistances (SVR and PVR), right and left ventricular stroke work index (RVSWI and LVSWI), rate-pressure product (RPP) and pressure-rate quotient (PRQ) were recorded prior to (baseline) and at 1, 3, 5, 10, 15, 20 and 30 min after administration of the drug. RESULTS: One minute after administration of the drug there was a maximum decrease in SAP (-26%), DAP (-17%), SVR (-22%), RVSWI (-23%), RPP (-24%) and PRQ (-22%) (p < 0.001 in all cases) and this continued to be significant throughout the study for SAP, DAP and RPP, and for SVR, RVSWI and PRQ at times 15, 3 and 10, respectively. There were no significant changes in HR, CO, ventricular filling pressures and the remaining variables during the study. CONCLUSIONS: Propofol produces the greatest decrease in systemic arterial pressure 1 min after administration and this decrease was maintained during the 30 min that our study lasted, due to a decrease in SVR but not in CO or in ventricular filling pressures.