Propofol

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Background

-an ultrashort-acting sedative alkylphenol derivative that induces deep sedation

-rapid onset (90-100 seconds) and short duration (2-8 minute half-life)


Contraindications

-allergy to soy or eggs

-hypotension

-aortic stenosis


Higher-risk of complications:

1. Patients >55 years old

2. Debilitated patients

3. Patients with significant underlying illness (i.e. ASA physical status score III or IV)


  • Optimize volume status before administration


Side Effects

1. Respiratory depression

2. Transient hypotension

3. Pain at injection site (inject lidocaine IV first)


Dose

induction = 1mg/kg IV, followed by 0.5mg/kg every 2-3 minutes as needed

Small incremental doses (10-30mg) can slowly be administered to effect


Adjunctive medications:

-fentanyl or morphine (propofol does not provide analgesia)

-NS for transient hypotension

-Lidocaine flush (to reduce injection pain)


Pediatric Population

Safe for procedural sedation in pediatric patients. Same dosing.