Effects of postoperative sedation with propofol and midazolam on pancreatic function assessed by pancreatitis-associated protein

• Published in: Anaesthesia Vol. 56; no. 9; pp. 836 - 840
• Main Authors: PIPER, S. N, KUMLE, B, MALECK, W. H, SUTTNER, S. W, FENT, M. T, BOLDT, J
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell 01.09.2001
• Subjects: Acute-Phase Proteins - metabolism; Adult; Aged; Antigens, Neoplasm; Biological and medical sciences; Biomarkers - blood; Biomarkers, Tumor; Cholesterol - blood; Conscious Sedation - methods; Critical Care - methods; Drug toxicity and drugs side effects treatment; Female; Hemodynamics - drug effects; Humans; Hypnotics and Sedatives - pharmacology; Lectins, C-Type; Male; Medical sciences; Midazolam - pharmacology; Middle Aged; Pancreas - drug effects; Pancreas - physiopathology; Pancreatitis-Associated Proteins; Pharmacology. Drug treatments; Postoperative Care - methods; Propofol - pharmacology; Prospective Studies; Toxicity: digestive system; Triglycerides - blood; Human; Postoperative; Intensive care; Amylase; Enzyme; Cholesterolemia; Toxicity; Triacylglycerol lipase; Esterases; Sedation; Carboxylic ester hydrolases; Surgery; Digestive diseases; Hydrolases; Benzodiazepine derivatives; Midazolam; Propofol; Sedative; Pancreas; Comparative study; Pancreatic disease; Triglyceridemia
• ISSN: 0003-2409; 1365-2044
• DOI: 10.1046/j.1365-2044.2001.02175.x

This prospective randomised controlled study evaluated the effects of postoperative sedation with propofol and midazolam on pancreatic function. We studied 42 intensive care unit patients undergoing elective major surgery who were expected to be sedated postoperatively. Patients were randomly assigned to a propofol group (n = 21) or a midazolam group (n = 21). To assess pancreatic function, the following parameters were measured: pancreatitis-associated protein, amylase, lipase, cholesterol and triglyceride prior to start of sedation on the intensive care unit, 4 h after the sedation was started and at the first postoperative day. Patients in the propofol group received on average (SD) 1292 (430) mg propofol and were sedated for 9.03 (4.26) h. The midazolam group received 92 (36) mg midazolam and were sedated for 8.81 (4.68) h. Plasma cholesterol concentrations did not differ significantly between groups. Triglyceride plasma levels 4 h after the start of infusion were significantly higher in the propofol group (140 (54) mg.dl(-1)) than the midazolam-treated patients (81 (29) mg.dl(-1)), but were within normal limits. There were no significant differences between the two groups regarding amylase, lipase and pancreatitis-associated protein plasma concentrations at any time. No markers of pancreatic dysfunction were outside the normal range. We conclude that postoperative sedation with propofol induced a significant increase of serum triglyceride levels but that pancreatic function is unchanged with standard doses of propofol.