Propofol on Blood Pressure

The effect of propofol on blood pressure is that it decreases systemic blood pressure.

This decrease in propofol blood pressure is often accompanied by corresponding changes in cardiac output and systemic vascular resistance.

Propofol decreases afterload more than thiopental and thus reduces systemic arterial pressure more than thiopental.

Propofol preferentially decreases SVR without a significant change in venous capacitance. The peripheral vascular actions of propofol appear to be due primarily to an inhibition of sympathetic vasoconstrictor nerve activity.

The effects of propofol on blood pressure may be exaggerated in hypovolaemic patients, elderly patients, and patients with compromised left ventricular function due to coronary artery disease. Adequate hydration before rapid IV administration of propofol is recommended to minimize the blood, pressure effects of this drug.

Propofol on blood pressure decreases systemic vascular resistance in children with congenital, heart defects. In children with cardiac shunt, this result in a decrease in the ratio of pulmonary to systemic blood flow leading to arterial desaturation.

Infusion of a sedative dose of propofol decreases systemic and pulmonary arterial pressure by decreasing systemic and pulmonary vascular resistance, respectively.

Among the effect of propofol on blood pressure is that it also decreases cardiac output mainly by a decrease in stroke volume. A negative inotropic effect of propofol may result from a decrease in intracellular calcium availability secondary to inhibition of trans sarcolemmal calcium influx.

But the net effect on myocardial contractility is insignificant at clinical concentrations, probably because of a simultaneous increase in the sensitivity of the myofilaments to Ca2. Baroreflex mediated increases in heart rate and systemic vascular resistance were less after propofol than after thiopentone.

The baroreceptor reflex was more attenuated in children aged less than 2 yr than in older children. Such were the effects of propofol on blood pressure.

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