Effects of postoperative sedation with propofol and midazolam on pancreatic function assessed by pancreatitis-associated protein

This prospective randomised controlled study evaluated the effects of posto perative sedation with propofol and midazolam on pancreatic function. We st udied 42 intensive care unit patients undergoing elective major surgery who were expected to be sedated postoperatively. Patients were randomly assign ed to a propofol group (n = 21) or a midazolam group (n = 21). To assess pa ncreatic function, the following parameters were measured: pancreatitis-ass ociated protein, amylase, lipase, cholesterol and triglyceride prior to sta rt of sedation on the intensive care unit, 4 h after the sedation was start ed and at the first postoperative day. Patients in the propofol group recei ved on average (SD) 1292 (430) mg propofol and were sedated for 9.03 (4.26) h. The midazolam group received 92 (36) mg midazolam and were sedated for 8.81 (4.68) h. Plasma cholesterol concentrations did not differ significant ly between groups. Triglyceride plasma levels 4 h after the start of infusi on were significantly higher in the propofol group (140 (54) mg.dl(-1)) tha n the midazolam-treated patients (81 (29) mg.dl(-1)), but were within norma l limits. There were no significant differences between the two groups rega rding amylase, lipase and pancreatitis-associated protein plasma concentrat ions at any time. No markers of pancreatic dysfunction were outside the nor mal range. We conclude that postoperative sedation with propofol induced a significant increase of serum triglyceride levels but that pancreatic funct ion is unchanged with standard doses of propofol.