Propofol-related infusion syndrome happened in a non-critically ill perioperative young patient: A case report

Propofol is a commonly used sedative for the induction of clinical anesthesia and sedation maintenance in intensive care unit patients. However, in a minority of patients, prolonged infusion of propofol may cause metabolic acidosis, electrocardiographic abnormalities, arrhythmias, and rhabdomyolysis, a condition known as propofol-related infusion syndrome. If not promptly identified and managed, propofol-related infusion syndrome can be fatal. Propofol-related infusion syndrome typically occurs in critically ill patients in the intensive care unit and is less common in clinical surgical anesthesia. We herein report a case of a patient with hematospermia who developed propofol-related infusion syndrome perioperatively, receiving a large amount of propofol infusion in a short time due to agitation during anesthesia recovery. Arterial blood gas analysis indicated persistently increasing lactic acid and unresolving metabolic acidosis, leading to the patient's transfer to the intensive care unit for further treatment. During intensive care unit treatment, the patient received continuous propofol infusion for sedation, with doses reaching up to 10 μg/kg/min, and a total infusion duration of ~8 h. We highly suspected propofol-related infusion syndrome and discontinued propofol. The patient successfully recovered after continuous renal replacement therapy. Propofol-related infusion syndrome can occur in non-critically ill patients receiving short-term propofol; hence, caution is warranted when using this drug. Early blood purification therapy is recommended for a better recovery from propofol-related infusion syndrome, and alternative sedatives should be considered as needed.