Propofol results in higher incidence of bronchoconstriction in allergic patients.

INTRODUCTION Some reports showed allergic reaction to propofol. However, propofol has bronchodilating effect. The purpose of this study was to elucidate whether propofol is safely used for patients with allergy or bronchial asthma. METHODS Seventy females with bronchial asthma or allergic diseases and 70 females without any allergic diseases for mastectomy were randomly allocated to propofol group (Propofol-allergy group and Propofol-non-allergy group) or sevoflurane group (Sevoflurane-allergy group and Sevoflurane-non-allergy group). In the propofol group, anesthesia was induced with propofol and fentanyl, and maintained with propofol, fentanyl and 50% nitrous oxide in oxygen. In the sevoflurane group, anesthesia was induced with sevoflurane, 50% nitrous oxide in oxygen and fentanyl, and maintained with sevoflurane and 50% nitrous oxide in oxygen. Laryngeal mask airway was inserted. Wheezing detected by auscultation, increase of inspiratory pressure and change of the waveform of end-tidal carbon dioxide, and allergic reaction detected by skin rash during anesthesia were compared among the groups. RESULTS The number of patients who had wheezing was significantly larger in Propofol-allergy group than in other groups. CONCLUSIONS Propofol might induce bronchoconstriction with a higher incidence in allergic patients than in non-allergic patients, and than sevoflurane.