Wirkungsvergleich von Propofol in drei subhypnotischen Dosierungen im Rahmen der Tumor-Chemotherapie

Purpose: In anaesthesia and critical care propofol is often used as a hypnotic or sedative, There are some reports showing propofol as a mood-altering drug. The use of propofol in subanaesthetic doses, for example in antineoplastic chemotherapy, led to similar results. In previous studies it was hypothesised that these mood effects could also reduce chemotherapy-induced nausea and vomiting. The present prospective randomised double-blind study evaluated mood effects of different subanaesthetic doses of propofol in oncology patients who received antineoplastic chemotherapy. Methods: Propofol was applied in a double-blind and randomised manner as follows (N = 8 per group): Initial bolus of 0,1 mg/kg followed by a continuous infusion of l.0 mg/kgxh (group 1), 1.5mg/kgxh (group 2) or 2.0 mg/kgxh (group 3). Dependent variables were as behavioural (i.e. nausea and vomiting) as aspects of mood as somatic aspects. Results: Subanaesthetic doses of propofol showed different effects. In respect of somatic variables some well-known results were replicated, showing highest reduction of blood pressure under highest dose of propofol. With regard to psychic variables no deterioration of mood or feeling tone was seen. Rather, a reduction of anxiety and especially under 2.0 mg/kgxh an induction of well-being occurred. However, even propofol was used as the only 'anti-emetic' drug, patients reported no induction of nausea and vomiting during antineoplastic chemotherapy. Conclusions: Further studies are needed to specify the 'anti-emetic' effects of subhypnotic propofol in antineoplastic chemotherapy. Especially a comparison with a standard drug for the prevention of nausea and vomiting, such as ondansetron, will have to be conducted. The results of this study showed that a dose of propofol of 1.0 mg/kgxh after an initial bolus of 0.1 mg/kg is a useful reference dose.