Uses of Propofol: - General Anaesthesia General anaesthesia, Sedation Electroconvulsive therapy, obstetrics. Sedation in children <16 yr. Pregnancy, lactation.

General (Intravenous) anesthetics

Propofol is a sedative-hypnotic agent for use in the induction and maintenance of anesthesia or sedation. Intravenous injection of a therapeutic dose of propofol produces hypnosis rapidly with minimal excitation, usually within 40 seconds from the start of an injection (the time for one arm-brain circulation). The action of propofol involves a positive modulation of the inhibitory function of the neurotransmitter gama-aminobutyric acid (GABA) through GABA-A receptors.

How to use Propofol: Your doctor or nurse will give you this medicine. Kindly do not self-administer. Adult Dose: Intravenous Induction and maintenance of general anaesthesia Adult: Induction: 40 mg by inj or infusion every 10 sec. Usual dose: 1.5-2.5 mg/kg. Maintenance: 4-12 mg/kg/hr or intermittent bolus inj of 20-50 mg. Elderly: Including neurosurgical and debilitated patients: Infuse at a rate of 20 mg every 10 sec. Maintenance: 3-6 mg/kg/hr. Usual dose needed: 1-1.5 mg/kg. Sedation Adult: In diagnostic and surgical procedures: Initially, 6-9 mg/kg/hr by infusion given for 3-5 minutes or an alternative dose of 0.5-1 mg/kg by slow inj over 1-5 minutes. Maintenance: 1.5-4.5 mg/kg/hr infusion. Reduce maintenance dose by 20% for high-risk patients needing sedation. For ventilated patients: 0.3-4 mg/kg/hr by infusion. Monitor lipid concentrations if duration of sedation lasts >3 days. Child Dose: Intravenous Anesthesia Induction 3-16 years: 2.5-3.5 mg/kg IVP over 20-30 sec Maintenance 2 months to 16 years: 0.125-0.3 mg/kg/min IV

Reduce dose if given with nitrous oxide or halogenated anaesthetics. Increased sedative, anaesthetic and cardiorespiratory effects when used with other CNS depressants.

Electroconvulsive therapy, obstetrics. Sedation in children <16 yr. Pregnancy, lactation.

Common - Nausea - Headache - Vomiting - Local site pain - Slow heart rate - Decreased blood pressure >10% Hypotension (peds 17%; adults 3-26%),Apnea lasting 30-60 sec (peds 10%; adults 24%),Apnea lasting >60 sec (peds 5%; adults 12%),Movement (peds 17%; adults 3-10%),Injection site burning/stinging/pain (peds 10%; adults 18%) 1-10% Respiratory acidosis during weaning (3-10%),Hypertriglyceridemia (3-10%),Hypertension (peds 8%),Rash (peds 5%; adults 1-3%),Pruritus (1-3%),Arrhythmia (1-3%),Bradycardia (1-3%),Cardiac output decreased (1-3%; concurrent opioid use increases incidence).Tachycardia (1-3%) <1% Arterial hypotension,Anaphylaxis,Asystole,Bronchospasm,Cardiac arrest,Seizures,Opisthotic rxn,Pancreatitis,Pulmonary edema,Phlebitis,Thrombosis,Renal tubular toxicity Potentially Fatal: Apnoea, bradycardia, hypotension, convulsions; anaphylaxis.

Due to insufficient experience, propofol shall not be used during pregnancy. Propofol is rapidly distributed to the foetus and shall therefore not be used for obstetric anaesthesia. Safety to the neonate has not been established in cases, where propofol has been administered to lactating women.

Precaution: Paediatrics, elderly, hypovolaemia, epilepsy, lipid disorders, patients with increased intracranial pressure. Avoid rapid bolus doses in high risk patients. Emulsion formulation of propofol 2% should only be used in children >3 yr. Lactation: Excreted in breast milk; effect on nursing infant not known

Overdosage may cause cardiorespiratory depression. Respiratory depression should be treated by artificial ventilation with oxygen, and cardiovascular depression by lowering of the patient's head and elevating of his/her legs. Pressor agents and plasma expanders or Ringer-type electrolyte solutions may be used, if necessary.

Propofol should be stored at a temperature not exceeding 25º C. It must not be frozen. Any unused solution shall be discarded.

General (Intravenous) anesthetics

Short-acting, lipophilic sedative/hypnotic; causes global CNS depression, presumably through agonist actions on GABAa receptors.

Due to insufficient experience, propofol shall not be used during pregnancy. Propofol is rapidly distributed to the foetus and shall therefore not be used for obstetric anaesthesia. Safety to the neonate has not been established in cases, where propofol has been administered to lactating women.