Recovery and long-term renal excretion of propofol, its glucuronide, and two di-isopropylquinol glucuronides after propofol infusion during surgery

Abstract

After an infusion of propofol, patients excrete propofol and its metabolites in the urine over a period in excess of 60 h. We hypothesize that (re)absorption of propofol and its metabolites by the kidney is a major process in elimination and that the reabsorbed compounds are gradually conjugated in the kidney and excreted in the urine. One patient showed a different pharmacokinetic profile for which we currently have no explanation.

Comparison of GC/MS and LC/MS methods for the analysis of propofol and its metabolites in urine

“…The lower limit of detection (LLOD) of PG when TEA was used was about 0.48 ppb level by MRM mode and 0.38 ppb level by SIM mode. The LLOQ for PG was about 10 times lower in the present study than reported in previous studies [12,28].…”

Urinary propofol metabolites in early life after single intravenous bolus

“…Finally, it was recently documented that tubular reabsorption of propofol and its metabolites by the kidney is a major contributor to elimination during continuous administration of propofol in adults that results in propofol metabolites in urine up to 60 h after administration. 20 It is therefore striking that in the i.v. bolus model evaluated, the median recovery of propofol metabolites in the first 24 h urine collection is similar in neonates and adults.…”

Cognitive recovery after ambulatory anaesthesia based on desflurane or propofol: a prospective randomised study

“…max.%plasma%concentra/on% quick%redistribu/on% to%peripheral% compartments% slow%redistribu/on% back%to%the%central% compartment,% metabolism% bolus%dose% Fig.2 The figure illustrates the metabolic pathway of propofol through hydroxylation by CYP2B6 or glucuronidation by UGT1A9. The percentage stated below the respective enzyme illustrates the variation in metabolic pathway between individuals observed in several studies 10,34 .…”

“…The water soluble PG, 1-QG, 4-QG and 4-QS are excreted in the urine ( Figure 2). PG is considered to be the main metabolite even though there is a great interindividual variation (10-67%) 9,10,33,34 .…”