[Effects of propofol on blood concentration of cyclosporine]

Abstract

Objective: This study was designed to assess whether propofol modifies the blood concentrations of cyclosporine and lipoproteins, which bind cyclosporine.

Study design: Prospective open study.

Patients: Fifteen consecutive grafted patients, scheduled for surgery allowing them to resume their oral treatment postoperatively. Their immunosuppressive treatment, included cyclosporine (Cy A), at a steady-state dosage.

Methods: Blood samples were drawn and residual Cy A blood concentrations were measured the days before and after anaesthesia and before and immediately after discontinuing the propofol infusion. Serum triglycerides, cholesterol, high-density lipoprotein (HDL) concentrations were measured before and immediately after discontinuing the propofol infusion.

Results: The 15 patients were given propofol by infusion for 30-210 min (mean 85 +/- 59 min). They received a total dose of propofol of 696 +/- 497 mg, a total fentanyl dose of 175 +/- 82 micrograms, and a total midazolam dose of 2.8 +/- 0.8 mg. The residual cyclosporine blood concentrations were similar the day before (142 +/- 47 ng.mL-1) and following anaesthesia (128 +/- 46 ng.mL-1) (P = 0.08). Serum cholesterol concentrations were not significantly influenced by propofol infusion, but serum triglycerides levels increased (1.46 +/- 0.66 vs 1.97 +/- 0.81 g.L-1), and HDL and LDL levels decreased (0.54 +/- 0.20 vs 0.47 +/- 0.18 g.L-1; 1.44 +/- 0.42 vs 1.28 +/- 0.37 g.L-1).

Conclusion: Propofol by infusion does not modify the cyclosporine concentration. It is concluded that propofol may be a suitable agent for intravenous anaesthesia in cyclosporine treated patients, provided a close postoperative monitoring of cyclosporine blood concentrations is maintained.