Comparison of serum triglyceride levels with propofol in long chain triglyceride and propofol in medium and long chain triglyceride after short term anesthesia in pediatric patients

abstract: ...Background: Significant increase in serum triglyceride (ST) concentration have been described in adult population after prolonged administration of propofol formulation containing long chain triglyceride (LCT). Though, medium chain triglyceride-LCT (MCT-LCT) propofol when compared with LCT propofol for long-term sedation in adults resulted in identical triglyceride levels, the elimination of triglyceride was faster in patients administered MCT-LCT propofol. Materials and Methods: A total of 40 children were randomized into two groups of 20 each; Group I were induced with 1% LCT propofol (3 mg/kg) and Group II with 1% medium and LCT propofol and maintained with descalating dose of 20.15 and 10 mg/kg/h at 10 min intervals. Blood samples for ST concentration were obtained before induction of anesthesia, at the end of propofol infusion and 4 h after terminating propofol infusion. Results: ST levels were raised significantly above the basal values in both the groups but the rise was significantly higher in Group I ( P < 0.05). Four hours after stopping propofol infusion the triglyceride levels were similar to the basal values in Group II, whereas in Group I the values were significantly greater than the baseline ( P < 0.05) as well as those of Group II ( P < 0.05). No clinically significant adverse effect of hypertriglyceridemia was observed. Conclusion: Even short term anesthesia with LCT and MCT-LCT propofol (1%) leads to elevated ST levels. The increase in ST levels is less with MCT-LCT propofol and elimination of triglyceride is also rapid after terminating MCT-LCT propofol infusion.

... under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background: Significant increase in serum triglyceride (ST) concentration have been described in adult population after prolonged administration of propofol formulation containing long chain triglyceride (LCT). Though, medium chain triglyceride-LCT (MCT-LCT) propofol when compared with LCT propofol for long-term sedation in adults resulted in identical triglyceride levels, the elimination of triglyceride was faster in patients administered MCT-LCT propofol. Materials and Methods: A total of 40 children were randomized into two groups of 20 each; Group I were induced with 1% LCT propofol (3 mg/kg) and Group II with 1% medium and LCT propofol and maintained with descalating dose of 20.15 and 10 mg/kg/h at 10 min intervals. Blood samples for ST concentration were obtained before

... significant adverse effect of hypertriglyceridemia was observed. Conclusion: Even short term anesthesia with LCT and MCT-LCT propofol (1%) leads to elevated ST levels. The increase in ST levels is less with MCT-LCT propofol and elimination of triglyceride is also rapid after terminating MCT-LCT propofol infusion. Long chain triglyceride propofol medium chain triglyceride-long chain triglyceride propofol pediatric serum triglyceride INTRODUCTION Propofol, a sedative and hypnotic agent has become increasingly popular for induction and maintenance of anesthesia in children and adults.[ 1 ] It is also used extensively as a sedative agent in the intensive care unit for short and long-term sedation during mechanical ventilation.[ 1 2 ] Significant increase in serum triglyceride (ST) concentration have also been described in adult population particularly after prolonged administration which is attributed to propofol formulation containing long chain triglyceride (LCT).[ 3 4 5 6 ] Though, medium chain triglyceride-LCT (MCT-LCT) propofol when compared with LCT propofol for long-term sedation in adults (at least 48 h) resulted in identical triglyceride levels, the elimination of triglyceride was faster in patients administered MCT-LCT propofol.[ 7 ] Similarly, short term administration of LCT propofol in standard doses for sedation and anesthesia have led to a significant increase in triglyceride levels in children.[ 8 9 ] Furthermore, anesthetic doses of propofol have transiently increased pancreatic and hepatic enzymes in pediatric patients undergoing craniotomy and receiving phenytoin for antiepileptic prophylaxis.[ 10 ] The availability of propofol in two different fat emulsion based intravenous (IV) formulations necessitate a comparison of ST levels after short term administration of LCT and MCT-LCT propofol for induction and maintenance of anesthesia in children. MATERIALS AND METHODS The study protocol was approved by the Institutional Ethics Committee. After obtaining written informed consent from the parents or legal guardian, 40 American Society of Anesthesiologists I pediatric patients aged 3-12 years scheduled for elective surgery of 1-2 h duration were enrolled in this prospective randomized double-blind study. The children were randomly allocated to either Group I (1% LCT propofol) or Group II (1% MCT-LCT propofol) by computer generated random number tables. All the children fasted for 8 h for solid food and 2 h for clear fluid preoperatively and were premedicated with oral

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