Propofol
PROPOFOL
- ‘Agent of choice’ for daycare anaesthesia.
- Used ‘both’ for induction as well as maintenance of anaesthesia.
- Used for only ‘IV administration’ as 1% solution.
- An oil-based preparation.
- Propofol supports bacterial growth.
- Di-sodium edetate & sodium meta-bisulfate are used in propofol preparation retarding bacterial growth.
PHARMACOKINETICS:
- Milky white powder.
- Contains egg extract.
- Is preservative free – Hence, must be used within 6 hours.
- IV anaesthetic agent is highly protein bound & lipid soluble
DOSES:
- Induction dose in an adult – 1.5-2.5 mg/kg.
- Onset of action within 15 seconds.
- Last for 5 -10 in due to redistribution.
- Induction & recovery is smooth.
USES:
- Propofol, fentanyl, isoflurane – Most preferred for short day care surgeries.
- Used as i.v. anaesthetic drug of choice for sedation in ICU.
- Used as i.v. anaesthetic drug of choice for total intravenous anaesthesia (TIVA), when used along with Alfentanil.
- Safe in Porphyria.
- Used in patients with malignant hyperthermia.
ADVERSE EFFECTS:
- Causes pain on IV administration.
- Because of oil preparation.
- Low incidence of nausea & vomiting.
ACTION:
- Propofol has CNS, CVS & respiratory depressant effects.
- Has minimal effects on hepatic & renal systems.
CNS effects:
- Decreases cerebral blood flow.
- Decreases intracranial pressure
- Decreases intraocular pressure.
- Hence, cerebro-protective.
- Has no muscle relaxant property.
- Produces myoclonic jerking & muscle twitching.
CVS effects:
- Dose-dependent decrease in BP.
- Due to vasodilatation & myocardial depressant effect.
Respiratory effects:
- Respiratory depressant.
Other features:
- Strong anti-emetic & anti-pruritic.
- Anti-oxidant.
- Not be used in extremely ill patients.
- Because it causes `Propofol Infusion Syndrome’.
Propofol infusion syndrome:
- Associated with long-term propofol use.
- Is rare but fatal.
Characterised by:
- Lactic acidosis
- Lipaemic plasma
- Cardiac failure.
Exam Question
- Propofol intravenous induction agent is most suitable for day care surgery.
- Safe inducing agent in malignant hyperpyrexia is Propofol
- Propofol is associated with less residual impairment and low incidence of postoperative nausea and vomiting.
- Propofol intravenous anaesthetic agent is highly protein bound & lipid soluble.
- Propofol is painful on injecting intravenously, because of oil preparations.
- Propofol has no muscle relaxant property.
- Propofol undergoes hepatic metabolism.
- Propofol is safe in porphyria, anti-emetic effect, pleasant sedation & recovery.
- Propofol, Fentanyl, Isoflurane are most preferred for short daycare surgeries.
Don’t Forget to Solve all the previous Year Question asked on Propofol
