A comparison of the effect of isoflurane and propofol anesthesia on lipid profile

Background Anesthetic agents exert a direct effect on cell membranes by binding to ion channels and an indirect effect by modulating the physicochemical properties of the host lipid bilayers This results in an alteration in both the cell membrane protein function and lipid profile which in turn might affect the health of the individual. Objective We compared the effects of isoflurane and propofol on lipid profile: triglycerides (TG), total cholesterol (TCHL), low-density lipoprotein, and high-density lipoprotein (HDL) following general anaesthesia. Patients and methods This prospective study involved 60 ASA I and II adult patients aged 18–64 years planned for elective surgery under general anesthesia. They were randomized into propofol and isoflurane groups. Induction of anesthesia was with intravenous sodium thiopentone 5 mg/kg and atracurium 0.5 mg/kg. Patients in group I received isoflurane (0.8–1.5%) while those in group P had propofol infusion, 100–200 μg/kg/minute for maintenance. Blood samples were taken at pre-induction, immediate- and 24 h postoperatively for estimation of serum TG, TCHL, low-density lipoprotein, and HDL. Risk factors for postoperative dyslipidemia were determined. Result The mean values of TCHL, HDL, and TG in the immediate postoperative period was significantly higher in the propofol group compared with the isoflurane group ( P =0.003, 0.003, and 0.001, respectively). In the 24 h postoperative period only serum TG had a significantly higher mean value in the propofol group compared with the isoflurane group ( P =0.001). Overall, the duration of surgery and anesthesia, hypotension, are not independent predictors of hypertriglyceridemia. Conclusion Propofol anesthesia caused a significant increase in lipid profile compared with isoflurane. Propofol may therefore be unsafe in patients with baseline hyperlipidemia.