Green discoloration of urine after propofol infusion
A 19-year-old male patient with a history of epilepsy was admitted to the ER for generalized convulsive status epilepticus. The patient was admitted to the ICU and we instigated mechanical ventilation under deep sedation with propofol. On admission to the ICU, the following laboratory results were found: albumin, 3.2 g/dl; total bilirubin, 1.1 mg/dl; AST, 44 U/L; ALT, 38 U/L; BUN, 14.7 mg/dl; and creatinine, 1.1 mg/dl. After titration, adequate depth of sedation was acquired at a rate of 3.5 mg/kg/h. The patient's urine changed to a green color 6 hours after the continuous infusion of propofol (). Blood examination revealed a serum albumin level of 3.0 g/dl, total bilirubin level of 1.1 mg/dl, and direct bilirubin 0.5 mg/dl. Urinalysis revealed the following: pH, 6.0; urine SG, 1.015; bilirubin content, negative; and urobilinogen level, 0.2 EU/dl. Even before the urine culture results were available, we suspected propofol to be the cause of the green urine. The urine color returned to normal 3 hours after discontinuation of propofol. A repeat urinalysis showed: pH, 7.0; urine SG, 1.020; bilirubin content, negative; and urobilinogen level, 8.0 EU/dl. After 2 days, we confirmed the cessation of seizure activity and transferred the patient to the general ward.