Name: PROPOFOL (DiprivanR)
Classification: short acting general anesthetic agent
  • low doses may be used as sedation of intubated, mechanically ventilated patients
  • short action useful for patients where rapid reversal is desired (e.g. neurological injuries)
  • may provide some cerebral protection
  • can be used in status epilepticus for refractory seizures
  • bronchodilator properties may be useful in treating status asthmaticus
Dose:
  • induction of general anesthesia: 
    • 2-2.5 mg/kg IV administered at a rate of 40 mg q10seconds until induction onset
  • maintenance of general anesthesia: 
    • 6-12mg/kg/hr IV
  • surgical diagnostic sedation: 
    • 0.5-1mg/kg over 3-5 minutes, followed by 1.5-4.5 mg/kg/h for continued sedation
  • maintenance of ICU sedation: 
    • 0.3mg/kg/h, increased by increments of 0.3- 5mg/kg/hr q5min until desired level of sedation and target VAMAAS
    • MAXIMUM DOSE 5 mg/kg/hr (.5 cc/kg/hr) (higher doses have been associated with heart failure when administered to neuro patients)
    • may administer boluses of 10-20 mg to rapidly increase sedation in patients not prone to hypotension
    • may need to decrease dose by 20-30% in elderly, debilitated or hypovolemic patients
Administration:
  • infuse undiluted; if wish to dilute prior to administration, use only D5W and do not dilute to a concentration <2mg/ml
  • do not use if evidence of separation of the emulsion
  • discard any unused portions
  • must change IV tubing and bottles q12h when running as a continuous infusion
  • maintain strict aseptic technique during handling as vehicle can support rapid bacterial growth
  • should be weaned off to prevent rapid reversal of sedation
Adverse Effects:
  • hypotension 
  • bradycardia, arrhythmias
  • apnea, airway obstruction 
  • seizures
  • cough 
  • hyperlipidemia
  • excitatory phenomena (spontaneous musculoskeletal movements and twitching and jerking of hands, arms, feet or legs)
  • headache, dizziness, agitation, anxiety, confusion, hallucinations, disinhibition upon awakening
  • nausea, vomiting, abdominal cramping
  • may discolour urine green
Contraindications:
  • do not give to patients allergic to soybean oil or egg phosphatide
  • Continuous infusion is not recommended for use in children < 18 years of age.
Drug Interactions:
  • propofol + narcotics = may increase propofol effect
  • propofol + other sedatives = may increase propofol effect
Monitoring Therapy:
  • HR, ECG
  • BP
  • level of sedation, anesthesia
  • oxygen saturation
CCTC Protocol:
  • May be administered by IV infusion by an approved nurse in CCTC.
  • Continuous infusion must be administered via an infusion pump.


Lynne Kelly, Pharmacist, CCTC
Brenda Morgan, Clinical Nurse Specialist, CCTC
Last Update: January 12, 2017

LHSCHealth Professionals

Last Updated January 12, 2017 | © 2007, LHSC, London Ontario Canada