PROPOFOL

It is a surgical anaesthetic having rapid/predictable induction, non accumulation, quick/smooth emergence, good tolerance, minimal cardiorespiratory adversity on careful administration.

Indications

Induction or maintenance of anaesthesia in cardiology, neurology, paediatric surgery. ICU sedation in ventilated adults. Status epilepticus, nausea/vomiting, intubation, pruritus, sedation following cardiac surgery. Torticollis, cardiovascular, MRI, malignant hyperthermia, obstetric analgesia.

Dosage

It should be administered intravenously. Induction: Adult: 2-2.5 mg/kg, Elderly: 1-1.5 mg/kg, Cardiac surgery: 0.5-1.5 mg/kg, Neurology: 1-2 mg/kg, Children: 2.5-3.5 mg/kg over 20-30 secs. Maintenance: Adult: 6-12 mg/kg/hr, Elderly: 3-6 mg/kg/hr, Primary & Secondary opioids: 50-100 & 100-150 resp., Neurology: 6-12 mg/kg/hr, Children: 7.5-18 mg/kg/hr. Maintenance intermittent: Adults: 20-50 mg increment as required. Monitored anaesthesia care: Initiation: 6-9 mg/kg/hr over 3-5 min or 0.5 mg/kg

Contra-Indications

Hypersensitivity.

Special Precautions

Hypovolaemia, epilepsy, dyslipidaemia, increased ICP, ECT, concurrent medications. Paediatrics: General anaesthesia in age below 3 yrs. and MAC all aged not recommended. Pregnancy: Anaesthesia: Use only if clearly indicated. Not recommended during delivery time. Lactation: Not recommended. Elderly: Reduce dose as per body wt.

Side Effects

Severe pain on injection, postoperative nausea/vomiting, neuromuscular excitation, ophthalmoplegia, rash, anaphylaxis, tolerance, abuse potential, green urine, Increased recovery time.

Drug Interactions

Opioids, muscle relaxants/neuromuscular blockers increase anaesthesia, respiratory depression (opioids) and decrease the HR (suxa-methonium), heart block/asystole. Midazolam, thiopentol, fentanyl, alfentanyl increases hypnosis.