Propofol Clearance and Volume of Distribution Are Increased in Patients With Major Burns

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Propofol pharmacokinetics were examined in 17 adults with major burns during the hyperdynamic convalescent phase. Eighteen nonburned surgical patients served as controls. After a 2-mg/kg intravenous dose of propofol, blood samples were collected at multiple time points. Noncompartmental methods were used to calculate the pharmacokinetic parameters. The following indices were higher in burns than controls: propofol clearance (64 ± 17 vs 29 ± 4 mL/kg/min, P < .001) and volume of distribution (8 ± 3 vs 4 ± 1 L/kg, P < .001). The area under the curve was smaller in burns (556 ± 152 vs 1193 ± 183 μg/mL h, P < .001). The higher clearance of propofol in burned patients may imply that these patients require higher doses or infusion rates of propofol to attain a target plasma concentration or pharmacodynamic effect.

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