Propofol Infusion Syndrome Associated with Short-Term Large-Dose Infusion During Surgical Anesthesia in an Adult

Abstract

In Brief In this case report we describe a case of propofol infusion syndrome in an adult after a short-term infusion of large-dose propofol during a neurosurgical procedure. Large-dose propofol (9 mg · kg−1 · h−1) was given for only 3 h during surgery and was followed by a small-dose infusion (2.3 mg · kg−1 · h−1) for 20 h postoperatively. The patient had also received large doses of methylprednisolone. He developed a marked lactic acidosis with mild biological signs of renal impairment and rhabdomyolysis but no cardiocirculatory failure. There were no other evident causes of lactic acidosis as documented by laboratory data. We believe this is the first report of reversible lactic acidosis associated with a short duration of large-dose propofol anesthesia. IMPLICATIONS: Although general anesthesia with propofol is usually extremely safe, after large-dose infusion some patients may experience lactic acidosis, rhabdomyolysis, renal impairment, and eventually cardiac failure. We report a recent neurosurgical case with the use of steroids as a possible triggering factor.