Jeffrey White, MD, an associate professor of anesthesiology and an associate medical director of GI Endoscopy, and Samsun Lampotang, PhD, a professor of anesthesiology at the University of Florida College of Medicine, in Gainesville, discussed their study on the different responses to propofol dosing for Asian, black and white patients during gastrointestinal endoscopy.
Upon noticing that most of the propofol dosing guidelines were based on research that only looked at white patients, Drs. White and Lampotang decided to examine the propofol dose requirements among Asian and black patients, conceiving that race might influence propofol dose requirements. For Dr. Lampotang, his interest in the study was based partially on a personal experience.
After undergoing a colonoscopy with sedation provided by propofol, Dr. Lampotang noted that he awoke an hour later than he had anticipated. Years later, he received another colonoscopy and asked for the propofol to be titrated. He received only a third of what he was given the first time, as expected, and awoke on time. The study was conducted using three groups with 29 patients of each race (Asian, black and white). The groups were further stratified by age, weight and sex.
They found a spectrum of response to propofol based on race that was often ignored: White patients were least sensitive to the dosing, whereas Asian patients were most sensitive. In fact, both Asian (31.08%) and black (16.44%) patients required less propofol dosing than white patients. When matched for age, weight and sex, there was no difference between the three groups, which the presenters said supports the idea that race should be considered along with weight when dosing propofol.
The research was presented by both researchers at the 2017 annual meeting of the American Society of Anesthesiologists, in Boston (abstract A3043).