Propofol pancreatitis

Devlin JW, Lau AK, Tanios MA. Propofol-associated hypertriglyceridemia and pancreatitis in the intensive care unit an analysis of frequency and risk factors. Pharmacotherapy 2005 25(10) 1348-52. 

There have been several reports of postoperative pancreatitis in association with propofol-induced anesthesia (61-63). In view of the very widespread use of propofol for induction of anesthesia, the very rare reports, and the complexity of establishing the cause of acute pancreatitis, a causal relation between propofol and pancreatitis has not been clearly established. 

A healthy 35-year-old man developed acute pancreatitis a few hours after receiving a 15-minute propofol anesthetic for laser treatment of a urethral stricture (64). He spent 3 weeks in an intensive care unit, requiring both respiratory and renal support. There was no evidence of gallstones on abdominal imaging. There was no defect of lipid metabolism. 

A 51-year-old woman with a past medical history of a seizure disorder, schizophrenia, and asthma, who had been admitted with pneumonia, was sedated using a propofol infusion to assist mechanical ventilation (65). Over 7 days she received a total of 26.5 g of propofol at a maximum rate of 0.2 mg/kg/minute. When pancreatitis, which was associated with hypertriglyceridemia, was diagnosed, the propofol infusion was stopped. In addition to raised amylase activity, serum triglyceride concentrations peaked at 17 mmol/1 and lipase activity at 564 U/1. She recovered over the next 7 days. On day 17 she underwent tracheostomy revision, during which... 

A healthy 21-year-old woman developed acute pancreatitis a day after an anesthetic that lasted 138 minutes, with propofol for induction (66). She recovered after supportive therapy for 6 days. There was no evidence of gallstones on abdominal imaging and there was no defect in lipid metabolism. 

The association between propofol and pancreatitis has been listed as probable in 25 reports of pancreatitis associated with propofol to the FDA registry. However, the features of this case, which included resolution of pancreatitis on drug withdrawal and recurrence on rechallenge, suggested that the association should be upgraded to definitely causal. ... 

Leisure GS, O Flaherty J, Green L, Jones DR. Propofol and postoperative pancreatitis. Anesthesiology 1996 84(l) 224-7. 

Wingfield TW. Pancreatitis after propofol administration is there a relationship Anesthesiology 1996 84(1) 236. 

Betrosian AP, Balia M, Papanikolaou M, Kofinas G, Georgiadis G. Post-operative pancreatitis after propofol administration. Acta Anaesthesiol Scand 2001 45(8) 1052. 

Kumar AN, Schwartz DE, Lim KG. Propofol-induced pancreatitis recurrence of pancreatitis after rechaUenge. Chest 1999 115(4) 1198-9. 

Jawaid Q, Presti ME, Neuschwander-Tetri BA, Burton FR. Acute pancreatitis after single-dose exposure to propofol a case report and review of literature. Dig Dis Sci 2002 47(3) 614-18. 

Pancreas Propofol can reportedly cause pancreatitis, perhaps because of alterations in lipid metabolism, leading to hypertriglyceridemia, release of free fatty acids, and chylomicron plugging of pancreatic capillaries. In a retrospective case note review of 479 children with acute leukemia who underwent general anesthesia for a... 

Ture H, Mercan A, Koner O, Aykac B, Jure U. The effects of propofol infusion on hepatic and pancreatic function and acid-base status in children undergoing craniotomy and receiving phenytoin. Anesth Analg 2009 109(2) 366-71. 

Crawford MW, Pehora C, Lopez AV. Drug-induced acute pancreatitis in children receiving chemotherapy for acute leukemia does propofol increase the risk Anesth Analg 2009 109(2) 379 1. 

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