Propofol clearance and volume of distribution are increased in patients with major burns.

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 microg/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.