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Propofol

General Anesthetic

  • Short-acting lipophilic IV general anesthetic
  • Hypnotic sedative

 

CCP: Induction or maintenance of general anesthesia

 

  • 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

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

CCP: All indications

  •  Induction
    • 2.5-3.5 mg/kg healthy pediatrics
  • Maintenance
    • 0.125- 0.3 mg/kg/min 
  • GABAA agonist
  • reduced glutamateric activity through NMDA receptor blockade

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

 

  • Hypotension
  • Bradycardia
  • involuntary body movements
  • Local burning sensation
  • Apnea
  • Hypertriglyceridemia
  • Hypotension
  • Myoclonus
  • Propofol-related infusion syndrome

No specific antidote.

Treatment is supportive in nature due to the fast half-life.

  • Anaphylaxis/hypersensitivity reactions
  • ECG effects: possible QT prolongation
  • Hypertriglyceridemia
  • CNS depressants
  • Opioids
  • Blood pressure lowering medications
  • Heart rate lowering medications

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