Generic
Propofol
6 brands available in the market
At a glance
Propofol is a highly lipid soluble, short-acting intravenous general anesthetic used for induction and maintenance of general anesthesia, sedation during intensive care, and sedation for surgical and diagnostic procedures.
Description
Propofol is a sedative-hypnotic agent for use in induction and maintenance of anesthesia or sedation. Intravenous injection produces hypnosis rapidly, usually within 45 seconds. The action of propofol involves positive modulation of the inhibitory function of GABA through GABA-A receptors.
Indications
- Induction and maintenance of general anesthesia
- Sedation during intensive care
- Sedation for surgical and diagnostic procedures
Therapeutic class
General (Intravenous) anesthetics
Pharmacological class
Sedative-Hypnotic (GABA-A Agonist)
Pharmacology
Propofol is a highly lipid soluble, short-acting IV general anesthetic. It works through positive modulation of GABA's inhibitory function via GABA-A receptors. Onset of general anesthesia occurs within 15-45 seconds. Most patients recover rapidly without confusion or nausea.
Mechanism of action
Provides anesthesia and sedation by causing CNS depression through GABA-A receptor activation.
Dosage
Adult Dose (IV):
- General anesthesia induction: 40 mg every 10 seconds; usual dose 1.5-2.5 mg/kg
- Maintenance: 4-12 mg/kg/hr OR intermittent bolus 20-50 mg
- Elderly/neurosurgical: 20 mg every 10 seconds; maintenance 3-6 mg/kg/hr; dose 1-1.5 mg/kg
- Sedation (diagnostic/surgical): 6-9 mg/kg/hr for 3-5 min OR 0.5-1 mg/kg slow IV over 1-5 min; maintenance 1.5-4.5 mg/kg/hr
- Ventilated patients: 0.3-4 mg/kg/hr
Pediatric Dose (IV):
- Anesthesia induction (3-16 years): 2.5-3.5 mg/kg over 20-30 sec
- Maintenance (2 months-16 years): 0.125-0.3 mg/kg/min
- Under 3 years: Not recommended
Administration
- Administered by healthcare professional as IV injection or infusion
- Do not self-administer
- May be diluted with 5% dextrose (use within 6 hours)
- May be mixed with lidocaine to reduce injection pain
Missed dose
If you miss a dose, consult your doctor.
Side effects
Side Effects:
- Injection site pain
- Hypotension
- Transient apnea
- Headache
- Nausea
- Vomiting
- Bradycardia
- Seizures (rare)
- Hypersensitivity reactions
- Green or reddish-brown urine discoloration (with prolonged administration)
Precautions & warnings
- Should only be given by specialists in anesthesiology or under their supervision
- Resuscitation facilities must be available
- Caution in cardiac, respiratory, renal, or hepatic insufficiency
- Caution in hypovolemic patients
- May cause convulsions in epileptic patients
- Do not drive or operate machinery after administration
Contraindications
- Allergy to propofol or any ingredient
- Electroconvulsive therapy
- Obstetrics
- Sedation in children <16 years
- Pregnancy and lactation
Drug interactions
- Nitrous oxide or halogenated anesthetics: Reduce dose
- Other CNS depressants: Increased sedative, anesthetic, and cardiorespiratory effects
- Opiates: May potentiate respiratory depression
Food interactions
Alcohol consumption with Propofol is unsafe.
Use in pregnancy
Use in Pregnancy: Generally considered safe; animal studies show low or no adverse effects; limited human studies; do not use in obstetrics.
Pregnancy Category: B — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Probably safe; limited human data suggests no significant risk.
Pediatric use
Not recommended for use in children under 3 years (safety not demonstrated); serious adverse events reported.
Geriatric use
Elderly patients require lower doses; caution required.
Renal / hepatic impairment
Renal Impairment: Safe in kidney disease; no dose adjustment needed; green urine discoloration may occur; consult your doctor.
Hepatic Impairment: Safe in liver disease; dose adjustment may not be needed; consult your doctor.
Overdose effects
Overdose may cause cardiorespiratory depression; treatment: artificial ventilation with oxygen, head lowering, leg elevation, pressor agents, plasma expanders if needed.
Storage conditions
Store at a temperature not exceeding 25°C; do not freeze; discard any unused solution.
Chemical structure
Propofol