Effects of Propofol and Midazolam Infusions on Serum Lipid and Glucose Levels in Hyperlipidemic Patients Undergoing Coronary Artery Bypass Surgery

Objective: Propofol has been accused for increasing plasma lipid levels during continuous infusion due to its lipid content. We aimed to show the effect and the risk of propofol infusion on plasma lipid and glucose levels in patients with hyperlipidemia undergoing coronary artery bypass graft surgery (CABG), and to compare them with a midazolam used control group. Material and Methods: In this randomized controlled study, 15 patients in the propofol group had anesthesia induction with intravenous propofol 1%, 2 mg/kg, fentanyl 10-15 mcg/kg, pancuronium 0.1 mg/kg, and the anesthesia was maintained with 1% 2-5 mg/kg/h propofol infusion, fentanyl 5-10 mcg/kg/hr, and an hourly pancuronium dose of 0.03 mg/kg The anesthetia management of 15 patients in midazolam group included induction with midazolam 0.1 mg/kg, fentanyl 10-15 mcg/kg, pancuronium 0.1 mg/kg, and infusion of midazolam 0.05-0.07 mg/kg/hr, fentanyl 5-10 mcg/kg/hr, and an hourly pancuronium dose of 0.03 mg/kg Plasma lipid [total cholesterol (CHL), triglyceride (TRG), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL)] and glucose concentrations were measured in both groups perioperatively, at seven different time points until 72 hours after the operation. Results: The decreases of TRG and HDL levels were statistically significant in the midazolam group. There were no significant differences for the decreases in CHL, LDL and VLDL levels between the groups. In both groups, plasma glucose levels increased significantly, independent from the propofol and midazolam infusions. Conclusion: We observed that propofol and midazolam anesthesia used in patients with hyperlipidemia undergoing to CABG did not have any effect on plasma lipid or glucose levels.