Propofol

Background

1. Rapid onset (90-100 seconds) and short duration (2-8 minute)
2. Wake up after induction dose usually 8-10 min
3. Seizure-like activity possible during induction, but safe in seizure disorder (most studies actually support anticonvulsant effect)
4. Has significant anti-emetic activity

Contraindications

1. Allergy to soy or eggs
2. Hypotension
3. Aortic stenosis

Higher Risk

1. Pts >55 yr
2. Debilitated patients
3. Pts w/ significant underlying illness (i.e. ASA physical status score III or IV)
   1. Optimize volume status before administration

Side Effects

1. Respiratory depression
2. Transient hypotension
3. Pain at injection site (inject lidocaine 20-40mg IV first)

Dose

1. Induction = 0.5-1mg/kg IV over 10s, followed by 0.5mg/kg every 2-3 minutes as needed
2. Small incremental doses (10-30mg) can slowly be administered to effect

Adjunctive medications

1. Fentanyl or morphine (propofol does not provide analgesia)
2. NS for transient hypotension
3. Lidocaine flush (to reduce injection pain)

Pediatric Population

1. Same dosing

See Also

• Sedation (Main)