Does epidural Blockade affect the Pharmacokinetics of Propofol in Surgical Patients?
Epidural blockade affects the pharmacokinetics of propofol and the performance of a target-controlled infusion of propofol. At an epidural ropivacaine dose that blocks 20 segments, the propofol dosage or target concentration may be reduced by 30% compared with when no epidural blockade is present. An epidural-induced reduction in hepatic and/or renal blood flow may explain this pharmacokinetic interaction.
There appears to be a low rate of screening for AAA within 1 primary care setting in a large VA health care system. If this finding is replicated within other VA primary health care settings, then the VA health care system should consider implementing a performance metric within primary care to improve AAA screening rates.