PROPOFOL

Indications & Dose:

Induction of anaesthesia using 0.5%or 1%injection

•   BY SLOW INTRAVENOUS INJECTION, OR BY INTRAVENOUS INFUSION

Adult 18–54 years: Usual dose 1.5–2.5 mg/kg, to be administered at a rate of 20–40 mg every 10 seconds until response, for debilitated patients use dose for 55 years and over

Adult 55 years and over: Usual dose 1–1.5 mg/kg, to be administered at a rate of 20 mg every 10 seconds until response

Induction of anaesthesia using 2%injection

•   BY INTRAVENOUS INFUSION

Adult 18–54 years: Usual dose 1.5–2.5 mg/kg, to be administered at a rate of 20–40 mg every 10 seconds until response. For debilitated patients use dose for 55 years and over

Adult 55 years and over: Usual dose 1–1.5 mg/kg, to be administered at a rate of 20 mg every 10 seconds until response

Maintenance of anaesthesia using 1%injection

•  INITIALLY BY INTRAVENOUS INFUSION

Adult: Usual dose 4–12 mg/kg/hour, alternatively (by slow intravenous injection) 25–50 mg, dose may be repeated according to response, for debilitated patients use dose for elderly

Elderly: Usual dose 3–6 mg/kg/hour, alternatively (by slow intravenous injection) 25–50 mg, dose may be repeated according to response

Maintenance of anaesthesia using 2%injection

•  BY INTRAVENOUS INFUSION

Adult: Usual dose 4–12 mg/kg/hour, for debilitated patients use dose for elderly

Elderly: Usual dose 3–6 mg/kg/hour

Sedation of ventilated patients in intensive care using 1%or 2%injection

•  BY CONTINUOUS INTRAVENOUS INFUSION

Adult: Usual dose 0.3–4 mg/kg/hour, adjusted according to response

Induction of sedation for surgical and diagnostic

procedures using 0.5%or 1%injection

•  BY SLOW INTRAVENOUS INJECTION

Adult: Initially 0.5–1 mg/kg, to be administered over 1–5 minutes, dose and rate of administration adjusted according to desired level of sedation and response

Maintenance of sedation for surgical and diagnostic procedures using 0.5%injection

•  INITIALLY BY INTRAVENOUS INFUSION

Adult: Initially 1.5–4.5 mg/kg/hour, dose and rate of administration adjusted according to desired level of sedation and response, followed by continued (by slow intravenous injection) 10–20 mg, (if rapid increase in sedation required), patients over 55 years or debilitated may require lower initial dose and rate of administration

Maintenance of sedation for surgical and diagnostic procedures using 1%injection

•  INITIALLY BY INTRAVENOUS INFUSION

Adult: Initially 1.5–4.5 mg/kg/hour, dose and rate of administration adjusted according to desired level of sedation and response, followed by (by slow intravenous injection) 10–20 mg, (if rapid increase in sedation required), patients over 55 years or debilitated may require lower initial dose and rate of administration

Maintenance of sedation for surgical and diagnostic procedures using 2%injection

•  INITIALLY BY INTRAVENOUS INFUSION

Adult: Initially 1.5–4.5 mg/kg/hour, dose and rate of administration adjusted according to desired level of sedation and response, followed by (by slow intravenous injection) 10–20 mg, using 0.5%or 1% injection (if rapid increase in sedation required), patients over 55 years or debilitated may require lower initial dose and rate of administration 

Contraindications:

 If history of propofol allergy,  bacterial contamination.

ABSOLUTE CONTRA INDICATION: Airway obstruction

Side Effects:

CVS depression, respiratory depression, excitatory Phenomena, pain at injection site, allergic reaction, post-operative nausea/vomiting, tremor, hiccup, ophthalmoplegia, rash, anaphylaxis. 

Cautions:

 Monitor blood lipid concentrations in patients at risk of fat overload. 

Precautions:

Interaction:

DRUGS

CNS depressants: Additive CNS depressant, respiratory depressant, and hypotensive effects; possibly decreased emetic effects of opioids droperidol: Possibly decreased control of nausea and vomiting ACTIVITIES

alcohol use: Additive CNS depressant, respi-ratory depressant, and hypotensive effects 

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Hypovolaemia, epilepsy, dyslipidaemia, increased  intracranial pressure, ECT, concurrent medication.

Pregnancy: Use only if clearly indicated. Not recommended for delivery or caesarian section.

Breast-feeding: Not recommended.

Old age: Reduced dose as per body wt.

BACTERIAL CONTAMINATION. In order to eliminate the risk of infection from  bacterial contamination strict aseptic technique must be used when drawing-up propofol emulsion 

Counselling:

Side Effects Or Adverse Reactions:

CV: Bradycardia, hypotension

GI: Nausea, vomiting

MS: Involuntary muscle movement (transient)

RESP: Apnea

Other: Anaphylaxis, injection-site burning, pain, or stinging

Patient And Carer Advice: