Impact of fospropofol disodium on lipid metabolism and inflammatory response in patients with hyperlipidemia: a randomized trial.

Abstract

Objective: This study aims to assess the impact of intravenous infusion of fospropofol disodium on lipid metabolism and the inflammatory response in individuals with hyperlipidemia.

Methods: A total of 360 preoperative individuals with hyperlipidemia were selected and randomly assigned to either the treatment group or the control group, with 180 participants in each group. The treatment group received an induction dose of fospropofol disodium at 10 mg/kg intravenously, followed by maintenance at a rate of 10 mg/(kg·h). The control group was administered propofol intravenously at 2 mg/kg for induction and maintained at 4 mg/(kg·h). All other medications were consistent between the two groups. Blood samples (3 ml of venous blood) were collected from patients at four-time points: 1 day before surgery (T₀), 3 h after anesthesia induction (T₁), 4 h post-surgery (T₂), and 24 h post-surgery (T3), to measure levels of triglycerides (TG), cholesterol (CHOL), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1), and apolipoprotein B (ApoB). C-reactive protein (CRP) and interleukin-6 (IL-6) levels were assessed at T₀ and T₃. Sedation onset time and adverse reactions were recorded for both groups.

Results: At T₀, the control group exhibited increased TG, CHOL, LDL-C, ApoB, and the ApoB/ApoA1 ratio, while the ApoA1 level had decreased. The LDL-C level and the ApoB/ApoA1 ratio showed significant increases (P < 0.01). Both groups showed elevated CRP and IL-6 levels at T₃ (P < 0.01). Compared to the control group, the treatment group demonstrated reduced levels of TG, CHOL, LDL-C, ApoB, and the ApoB/ApoA1 ratio at T₁-T₃, while ApoA1 levels were higher at T1-T2 (P < 0.01 or P < 0.05). The sedation onset time was notably longer in the treatment group, and the incidence of injection-related pain, respiratory depression, hypotension, and other adverse reactions was significantly lower (P < 0.01).

Conclusion: Compared with propofol, intravenous infusion of fospropofol disodium for more than 3 h during anesthesia has lesser impact on lipid metabolism in patients with hyperlipidemia and does not increase inflammatory factors levels.