Propofol
Classification
General Anesthetic
- Short-acting lipophilic IV general anesthetic
- Hypnotic sedative
Indications
CCP: Induction or maintenance of general anesthesia
Contraindications
- Hypersensitivity to Propofol or any component of the formulation:
- eggs or egg products
- soybeans or soy products
- Pediatrics < 3 years of age
- Patients in third trimester of pregnancy
Caution
- Hemodynamic instability
Adult dosages
CCP: All indications
Doses based on total body weight
- Induction
- 1-2.5mg/kg healthy adults
- 0.5-1 mg/kg hypotensive adults
- Maintenance
- 25-100 mcg/kg/min
Pediatric Considerations And Dosing
CCP: All indications
- Induction
- 2.5-3.5 mg/kg healthy pediatrics
- Maintenance
- 0.125- 0.3 mg/kg/min
Mechanism Of Action
- GABAA agonist
- reduced glutamateric activity through NMDA receptor blockade
Pharmacokinetics
Onset
- Anesthetic: Bolus infusion (dose dependent): 9 to 51 seconds (average 30 seconds)
Duration
- 3 to 10 minutes depending on the dose, rate and duration of administration
Distribution
-
Large volume of distribution; highly lipophilic ; Vd:
-
Children 4 to 12 years: 5 to 10 L/kg
-
Adults: 2 to 10 L/kg; after a 10-day infusion, Vd approaches 60 L/kg; decreased in the elderly
-
Protein binding: 97% to 99%
Metabolism
- Hepatic to water-soluble sulfate and glucuronide conjugates
Half-life
- 40 minutes
Adverse Effects
- Hypotension
- Bradycardia
- involuntary body movements
- Local burning sensation
- Apnea
- Hypertriglyceridemia
- Hypotension
- Myoclonus
- Propofol-related infusion syndrome
Overdose
No specific antidote.
Treatment is supportive in nature due to the fast half-life.
Warning And Precautions
- Anaphylaxis/hypersensitivity reactions
- ECG effects: possible QT prolongation
- Hypertriglyceridemia
Drug Interactions
- CNS depressants
- Opioids
- Blood pressure lowering medications
- Heart rate lowering medications