Propofol
Related Subjects:
|Respiratory Failure
|Non-invasive ventilation (NIV)
|Intubation and Mechanical Ventilation
|Critical illness neuromuscular weakness
|Haemodialysis
|Dobutamine
💤 Propofol provides rapid onset and offset of anaesthesia with smoother recovery than many other induction agents.
It is often associated with fewer postoperative effects such as drowsiness, nausea, and vomiting.
📖 About
- Always check the BNF link here for detailed prescribing advice.
- Widely used for induction of anaesthesia and ICU/ procedural sedation.
- Formulated as a white lipid emulsion due to poor water solubility.
⚙️ Mode of Action
- A hypnotic alkylphenol derivative that enhances inhibitory GABA-A receptor activity → CNS depression.
- Provides sedation, hypnosis, and amnesia but no analgesia (so usually combined with opioids).
- Metabolised mainly by the liver, excreted by the kidneys.
💉 Indication & Dose
- Induction of GA: 1.5–2.5 mg/kg IV (lower in elderly/frail).
- Onset: 20–40 seconds ⏱️.
- Recovery: 5–10 minutes after a bolus.
- Also used for maintenance (continuous infusion) and procedural sedation.
🔄 Interactions
- Refer to BNF – additive CNS depression with opioids, benzodiazepines, alcohol, and other sedatives.
⚠️ Cautions
- May cause marked hypotension – titrate carefully in elderly, hypovolaemic, or cardiac patients.
- Rarely, idiosyncratic liver injury or propofol infusion syndrome (PRIS) with prolonged high-dose use in ICU.
🚫 Contraindications
- See BNF for full list (e.g. allergy to propofol or its components such as soya/egg phosphatide emulsifiers).
💢 Side Effects
- Blood pressure drop: vasodilation, myocardial depression.
- Apnoea/respiratory depression 🌬️.
- Pain at injection site (often mitigated by lidocaine).
- Seizure-like movements (rare) but also has anticonvulsant activity.
- Rare: PRIS → metabolic acidosis, rhabdomyolysis, renal failure, cardiovascular collapse.
📚 References
