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NEUROSURGICAL ANESTHESIA

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

Department of Intensive Care, Laboratory of Neurophysiology, Department of Anesthesiology, Department of Neurosurgery, Cliniques Saint-Luc, Université catholique de Louvain, Brussels, Belgium

Address correspondence and reprint requests to Philippe Hantson, MD, PhD, Department of Intensive Care, Cliniques Universitaires St-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium. Address e-mail to hantson{at}rean.ucl.ac.be

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.

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