Propofol
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.
