Key result
Administration of propofol or its solvent Intralipid during surgery was associated with a significantly faster recovery of Apolipoprotein A-I levels at 24 hours compared to isoflurane alone.
Why the study?
Does propofol or its solvent Intralipid modulate Apolipoprotein A-I and the inflammatory response after surgical stress in patients undergoing laparoscopic inguinal hernia repair?
RCT (n=79)
Double-blind
Computer-generated table
No
Does propofol or its solvent Intralipid modulate Apolipoprotein A-I and the inflammatory response after surgical stress in patients undergoing laparoscopic inguinal hernia repair?
The administration of lipid emulsions (propofol or Intralipid) during surgery is associated with a more pronounced but rapidly recovering acute phase inflammatory reaction and blunted cortisol response.
The inflammatory properties of propofol are still debated. Apolipoprotein A-I is involved in the inflammation. We sought to determine how propofol or its solvent Intralipid® modulate Apolipoprotein A-I and the inflammatory response after surgical stress. Patients undergoing laparoscopic inguinal hernia repair were allocated to anesthesia with propofol (n=25), isoflurane alone (n=27) or in combination with Intralipid® (n=27). Apolipoprotein A-I and inflammation were assessed before, during and after surgery. Following a decrease in all groups, Apolipoprotein A-I levels tended to recover significantly earlier when propofol or Intralipid® were given (p<0.05). Cortisol increased in the control group whereas it remained at baseline levels when lipids were given. In this study the administration of lipids, i.e. propofol or its solvent Intralipid®, in the perioperative setting was associated with a more pronounced yet rapidly recovering acute phase reaction.
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Bandschapp et al. (2015) conducted an RCT in Healthy patients undergoing elective laparoscopic inguinal hernia repair (n=79). Propofol vs. Isoflurane alone (with thiopental induction) was evaluated on Gradient between Apolipoprotein A-I levels at baseline and 24 hours after skin incision (mg/dl) (p=0.048). Administration of propofol or its solvent Intralipid during surgery was associated with a significantly faster recovery of Apolipoprotein A-I levels at 24 hours compared to isoflurane alone.
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