Key result
Propofol anesthesia caused a significant increase in total cholesterol, HDL, and triglycerides in the immediate postoperative period compared with isoflurane (P=0.003, 0.003, and 0.001, respectively).
Why the study?
Anesthetic agents alter lipid bilayers and lipid profile, which might affect patient health, but the comparative effects of isoflurane and propofol were not fully defined.
Does propofol infusion increase lipid profile compared to isoflurane in adult patients undergoing elective surgery under general anesthesia?
RCT (n=60)
randomized
Does propofol infusion increase lipid profile compared to isoflurane in adult patients undergoing elective surgery under general anesthesia?
Propofol anesthesia significantly increases lipid profile (TCHL, HDL, TG) in the immediate postoperative period compared to isoflurane, suggesting caution in patients with baseline hyperlipidemia.
Propofol may raise lipids more than isoflurane; leaves open clinical relevance and need for confirmatory trials.
Background Anesthetic agents exert a direct effect on cell membranes by binding to ion channels and an indirect effect by modulating the physicochemical properties of the host lipid bilayers This results in an alteration in both the cell membrane protein function and lipid profile which in turn might affect the health of the individual. Objective We compared the effects of isoflurane and propofol on lipid profile: triglycerides (TG), total cholesterol (TCHL), low-density lipoprotein, and high-density lipoprotein (HDL) following general anaesthesia. Patients and methods This prospective study involved 60 ASA I and II adult patients aged 18–64 years planned for elective surgery under general anesthesia. They were randomized into propofol and isoflurane groups. Induction of anesthesia was with intravenous sodium thiopentone 5 mg/kg and atracurium 0.5 mg/kg. Patients in group I received isoflurane (0.8–1.5%) while those in group P had propofol infusion, 100–200 μg/kg/minute for maintenance. Blood samples were taken at pre-induction, immediate- and 24 h postoperatively for estimation of serum TG, TCHL, low-density lipoprotein, and HDL. Risk factors for postoperative dyslipidemia were determined. Result The mean values of TCHL, HDL, and TG in the immediate postoperative period was significantly higher in the propofol group compared with the isoflurane group ( P =0.003, 0.003, and 0.001, respectively). In the 24 h postoperative period only serum TG had a significantly higher mean value in the propofol group compared with the isoflurane group ( P =0.001). Overall, the duration of surgery and anesthesia, hypotension, are not independent predictors of hypertriglyceridemia. Conclusion Propofol anesthesia caused a significant increase in lipid profile compared with isoflurane. Propofol may therefore be unsafe in patients with baseline hyperlipidemia.
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Oladimeji et al. (2024) conducted an RCT in elective surgery under general anesthesia (n=60). Propofol vs. Isoflurane was evaluated on lipid profile (triglycerides, total cholesterol, LDL, and HDL) (p=0.003, 0.003, and 0.001). Propofol anesthesia caused a significant increase in total cholesterol, HDL, and triglycerides in the immediate postoperative period compared with isoflurane (P=0.003, 0.003, and 0.001, respectively).
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