Haemodynamic changes during anaesthesia induced and maintained with propofol.

The haemodynamic effects of propofol, given as a single dose of 2 mg kg-1 immediately followed by a continuous infusion of 6 mg kg-1 h-1, were studied in 10 elderly patients premedicated with lorazepam 1 mg i.v. All patients breathed room air spontaneously. Unconsciousness was successfully induced in all patients and persisted during the 60 min of the infusion. Statistically significant decreases in systolic and diastolic arterial pressures were observed 2 min after induction (28% and 19%, respectively) and during infusion (30% and 25%, respectively) and were related to decreases in systemic vascular resistance (21% following induction and 30% during infusion). Cardiac output was not affected at any time nor were stroke volume and heart rate. We conclude that the arterial hypotension associated with the induction and infusion of propofol is mainly a result of a decrease in afterload without compensatory increases in heart rate or cardiac output.