Propofol requirement for induction of unconsciousness is reduced in patients with Parkinson's disease: a case control study

Abstract

Parkinson's disease (PD) is the second most prevalent neurodegenerative disease, but whether the neurodegenerative process influences the pharmacodynamics of propofol remains unclear. We aimed to evaluate the effect of PD on pharmacodynamics of propofol. A total of 31 PD patients undergoing surgical treatment (PD group) and 31 pair-controlled non-PD patients undergoing intracranial surgery (NPD group) were recruited to investigate the propofol requirement for unconsciousness induction. Unconsciousness was induced in all patients with target-controlled infusion of propofol. The propofol concentration at which unconsciousness was induced was compared between the two groups. EC50 and EC95 were calculated as well. Demographic data, bispectral index, and hemodynamic values were comparable between PD and NPD groups. The mean target concentration of propofol when unconsciousness was achieved was 2.32 ± 0.38 μg/mL in PD group, which was significantly lower than that in NPD group (2.90 ± 0.35 μg/mL). The EC50 was 2.05 μg/mL (95% CI: 1.85-2.19 μg/mL) in PD group, much lower than the 2.72 μg/mL (95% CI: 2.53-2.88 μg/mL) in NPD group. In conclusion, the effective propofol concentration needed for induction of unconsciousness in 50% of patients is reduced in PD patients. (This trial is registered with NCT01998204.).

Figure 1

BIS, heart rate, systolic blood pressure, and diastolic blood pressure before and after propofol induction (n = 31 for both groups). PD: Parkinson's disease; NPD: non-Parkinson's disease; BIS: bispectral index. Results are given as mean (standard derivation). ^∗ P < 0.05 compared with before induction in both groups.

Figure 2

The target concentration of propofol when unconsciousness is induced by propofol. PD: Parkinson's disease; NPD, non-Parkinson's disease (n = 31 for both groups). Results are given as mean (standard derivation). ^∗ P < 0.05 compared with NPD group.