Propofol

INTRODUCTION:
  • Propofol is the 'agent of choice' for day care anesthesia.
  • Propofol is used for only 'IV administration' as 1% solution.
  • Causes pain on IV administration.
  • The induction dose in an adult is 1.5-2.5 mg/kg.
  • It is used 'both' for induction as well as maintenance of anesthesia.
  • Induction and recovery from propofol is smooth"
  • Incidence from nausea and vomiting is low.
  • Propofol has minimal effects on hepatic and renal systems.
  • Propofol supports growth of bacteria. As a result `disodium edetate and sodium meta bisulfate' are used in preparations to retard the growth of bacteria.-
  • Contains egg extract.
  • Propofol resembles barbiturates and also has 'anticonvulsant' properties.
  • Propofol is safe in Porphyria
  • Propofol intravenous anaesthetic agent is highly protein bound and highly lipid soluble
  • Propofol does not trigger malignant hyperthermia.
  • Propofol, fentanyl, isoflurane are the most preferred for short day care surgeries
ACTION:
CNS Effects are:
  • Decreases Cerebral blood flow
  • Decreases intracranial pressure
  • Decreases intraocular pressure.
  • Cerebroprotective
CVS Effects are:
  • Dose dependent decrease in BP due to vasodilatation as well as myocardial depressant effect.
Respiratory Effects are:
  • Propofol is a respiratory depressant
  • Remember Propofol has CNS, CVS and respiratory depressant effects.
Other Features of Propofol:
  • Antiemetic
  • Antipruritic
  • Antioxidant
  • Propofol should not be used in extremely ill patients as it causes `propofol infusion syndrome'.
Propofol infusion syndrome:
  • Associated with long-term propofol use.
  • Is rare but fatal.
  • Characterised by:
  1. Lactic acidosis
  2. Lipaemic plasma
  3. Cardiac failure.
Fos propofol:
Is water soluble and hence is associated with
  • ↓pain,
  • ↓hyperlipidemia
  • ↓risk of sepsis
  • It is used along with fentanyl especially for procedures like endoscopy, colonoscopy, bronchoscopy.
Exam Question of:
  • Propofol intravenous induction agent is most suitable for day care surgery
  • Safe inducing agent in malignant hyperpyrexia is Propofol
  • Propofol is associated with less residual impairment and low incidence of postoperative nausea and vomiting.
  • Propofol intravenous anaesthetic agent is highly protein bound and highly lipid soluble
  • Propofol is painful on injecting intravenously
  • Propofol has no muscle relaxant property
  • Propofol Undergoes hepatic metabolism
  • Propofol is Safe in porphyria, Antiemetic effect, Plesant sedation & recovery
  • Propofol, fentanyl, isoflurane are the most preferred for short day care surgeries

Don't Forget to Solve all the previous Year Question asked on Propofol