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Understanding Anesthesiology - The Global Regional Anesthesia ...

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Propofol<br />

Class<br />

Alkylphenol intravenous anesthetic agent. Used for induction of general anesthesia. Can<br />

also be used for maintenance of anesthesia or for sedation, in each case by continuous infusion.<br />

Mechanism of action<br />

Not well described.<br />

Dose<br />

Induction: 2-2.5 mg/kg IV for adults<br />

Induction: 3-4 mg/kg IV for children<br />

Maintenance of anesthesia:100-200 ug/kg/minute<br />

Sedation: 40-100 ug/kg/minute<br />

Onset<br />

Within one arm-brain circulation time (approximately 20 seconds).<br />

Duration<br />

Approximately 5-8 minutes after single induction dose.<br />

Elimination<br />

Rapid redistribution away from central nervous system (CNS) into lean body compartment<br />

accounts for prompt awakening. Metabolized by liver and extra-hepatic sites then excreted<br />

by kidney.<br />

Effects<br />

CNS<br />

Profound CNS depressant, potentiating the depressant effects of opioids, sedatives and volatile<br />

anesthetics. Decreases cerebral metabolic rate and intracranial pressure. Occasionally excitement,<br />

tonic-clonic movements or opisthotonus is seen on induction with propofol.<br />

CVS<br />

Causes direct myocardial depression and vasodilation leading to hypotension. Propofol must<br />

be used with caution in patients with poor left ventricular function or critical coronary artery<br />

insufficiency or in those who are seriously ill or debilitated.<br />

Respiratory<br />

Depression of respiratory centre leads to brief apnea. Propofol effectively blunts the airway’s<br />

response to manipulation thus hiccoughing and bronchospasm are rarely seen.<br />

Misc.<br />

Pain on injection seen in up to 20%. Mild anti-emetic properties. Patients often experience<br />

pleasant dreams under anesthesia followed by a smooth, clear-headed emergence. Strict<br />

aseptic technique must be used when handling propofol as the vehicle is capable of supporting<br />

rapid growth of micro-organisms.<br />

Contraindications<br />

Egg or soy allergy.<br />

Related Glossary Terms<br />

Continuous Infusion, Etomidate, Induction, Intralipid, Ketamine, Sodium Thiopental, Total<br />

intravenous anesthesia<br />

Index<br />

Find Term<br />

Chapter 3 - Anesthetic Techniques<br />

Chapter 3 - General <strong>Anesthesia</strong><br />

Chapter 3 - General <strong>Anesthesia</strong><br />

Chapter 6 - Drug Finder<br />

Chapter 6 - Induction Agents

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