Pharmacokinetic profile in relation to anaesthesia characteristics after a 5 micellar microemulsion of propofol in the horse

Abstract

BackgroundTo define the pharmacokinetic profile of propofol 5 microemulsion formulation in horses.MethodsFirst, propofol was administered as bolus injection (2 mg kg-1) to six xylazine-sedated horses. Secondly, after sedation and bolus injection, propofol was maintained with continuous infusion for 3 h [8.1 (sd 3.2) mg kg-1 h-1] to the same six horses. Thirdly, in two horses, a commercial propofol was used for comparison. Response to noxious stimulation was used to evaluate analgesia. Venous blood samples were obtained to measure propofol plasma concentration using liquid chromatography-mass spectrometry analysis. The plasma concentrations were related to the anaesthesia characteristics to determine the ED50.ResultsThe pharmacokinetic profile of propofol is best characterized by a non-compartmental model. The mean (confidence interval) for area under plasma concentration-time curve, elimination half-life, mean residence time, and clearance was 41 min g ml-1 (±7.7), 44.8 min (±21.3), 13.7 min (±3.2), and 45.8 ml min-1 kg-1 (±6.5), respectively. Linear regression analysis showed a correlation between plasma concentration and infusion rate (r2=0.47). Most propofol infusion rates did not inhibit the response to noxious stimulation and rates above 11.9 mg kg-1 h-1 caused involuntary muscle contractions. Better recoveries were associated with lower propofol plasma concentrations. Propofol plasma concentration frequently increased when horses woke from anaesthesia. ConclusionsCaution is warranted when propofol is used for continuous infusion due to variable kinetics, myoclonal activity, poor analgesia, and less desirable recovery quality.