F. Gamlin et al., The haemodynamic effects of propofol in combination with ephedrine in elderly patients (ASA groups 3 and 4), ANAESTH I C, 27(5), 1999, pp. 477-480
The marked vasodilator and negative inotropic effects of propofol are disad
vantages in frail elder ly patients. We investigated the safety and efficac
y of adding different doses of ephedrine to propofol in order to obtund the
hypotensive response. The haemodynamic effects of adding 15 20 or 25 mg of
ephedrine to 200 mg of propofol were compared to control in 40 ASA 3/4 pat
ients over 60 years presenting for genito-urinary surgery. The addition of
ephedrine to propofol appears to be an effective method of obtunding the hy
potensive response to propofol at all doses used in this study However; mar
ked tachycardia associated with the use of ephedrine in combination with pr
opofol occurred in the majority of patients, occasionally reaching high lev
els in individual patients. Due to the risk of this tachycardia inducing my
ocardial ischemia, we would not recommend the use in elderly patients of an
y of the ephedrine/propofol mixtures studied.