Overview
Propofol is a short-acting intravenous general anesthetic agent used for induction and maintenance of anesthesia, procedural sedation, and sedation in intensive care units. It provides rapid onset and recovery with minimal postoperative nausea.
Mechanism of Action
Enhances inhibitory neurotransmission mediated by GABA-A receptors in the central nervous system, leading to sedation, hypnosis, and anesthesia.
Indications
- Induction and maintenance of general anesthesia
- Sedation for mechanically ventilated adults in ICU
- Procedural sedation
Dosage
IV administration only. Induction: 1.5-2.5 mg/kg (adults), 2.5-3.5 mg/kg (children). Maintenance: 100-200 mcg/kg/min. ICU sedation: 5-50 mcg/kg/min. Titrate to effect.
Black Box Warning
Propofol injection should be administered only by persons trained in the administration of general anesthesia and not involved in the conduct of the surgical/diagnostic procedure. Patients should be continuously monitored, and facilities for maintenance of a patent airway, artificial ventilation, and oxygen enrichment and circulatory resuscitation must be immediately available.
Contraindications
- Hypersensitivity to propofol or components
- Allergy to eggs, egg products, soybeans, or soy products
- Patients with increased intracranial pressure or impaired cerebral circulation
Side Effects
- Hypotension
- Bradycardia
- Apnea
- Injection site pain
- Nausea/vomiting
- Myoclonus
- Green discoloration of urine
- Propofol infusion syndrome (rare but serious)
Interactions
- Enhanced CNS depression with other sedatives, opioids, or alcohol
- Increased risk of bradycardia with beta-blockers
- Potential interaction with drugs affecting CYP enzymes