Classifications: general anesthesia; sedative-hypnotic; Therapeutic: sedative-hypnotic; general anesthesia
Pregnancy Category: B
10 mg/mL injection
Sedative-hypnotic used in the induction and maintenance of anesthesia or sedation. Rapid onset (40 sec) and minimal excitation
during induction of anesthesia.
Effectively used for conscious sedation.
Induction or maintenance of anesthesia as part of a balanced anesthesia technique; conscious sedation in mechanically ventilated
Hypersensitivity to propofol or propofol emulsion, which contain soybean oil and egg phosphatide; obstetrical procedures;
patients with increased intracranial pressure or impaired cerebral circulation; lactation. Do not use for induction of anesthesia
in children <3 y and for maintenance of anesthesia in infants <2 mo.
Patients with severe cardiac or respiratory disorders or history of epilepsy or seizures; pregnancy (category B).
Route & Dosage
|Induction of Anesthesia
Adult: IV 22.5 mg/kg q10sec until induction onset
Adult (>55 y): IV 11.5 mg/kg q10sec until induction onset
Child (≥3 y): IV 2.53.5 mg/kg over 2030 sec
Maintenance of Anesthesia
Adult: IV 100200 mcg/kg/min
Adult (>55 y): IV 50100 mcg/kg/min
Child (≥3 y): IV 125300 mcg/kg/min
Adult: IV 5 mcg/kg/min for at least 5 min, may increase by 510 mcg/kg/min q510min until desired level of sedation is achieved
(may need maintenance rate of 580 mcg/kg/min)
- Use strict aseptic technique to prepare propofol for injection; drug emulsion supports rapid growth of microorganisms.
- Inspect for particulate matter and discoloration. Discard if either is noted.
- Shake well before use. Inspect for separation of the emulsion. Do not use if there is evidence of separation of phases of
PREPARE: IV Infusion: Give undiluted or diluted in D5W to a concentration not less than 2 mg/mL. Begin drug administration immediately after preparation
and complete within 6 h.
ADMINISTER: IV Infusion: ??Use syringe or volumetric pump to control rate. ??Determine rate by weight. ??Administer immediately after spiking the vial. Complete infusion within 6 h.
INCOMPATIBILITIES Y-site: Amikacin, amphotericin B, ascorbic acid, atracurium, bretylium, calcium chloride, ciprofloxacin, cisatracurium, diazepam, digoxin, doxorubicin, gentamicin, levofloxacin, methotrexate, methylprednisolone, metoclopramide, minocycline, mitoxantrone, netilmicin, phenytoin, tobramycin, verapamil.
- Store unopened between 4° C (40° F) and 22° C (72° F). Refrigeration is not recommended. Protect from
Adverse Effects (≥1%)CNS:
Headache, dizziness, twitching, bucking, jerking, thrashing, clonic/myoclonic movements. Special Senses:
Decreased intraocular pressure. CV:
Hypotension, ventricular asystole
Vomiting, abdominal cramping. Respiratory:
Cough, hiccups, apnea. Other:
Pain at injection site.
Diagnostic Test Interference
Propofol produces a temporary reduction in serum cortisol levels. However, propofol does not seem to inhibit adrenal responsiveness to ACTH.
Concurrent continuous infusions of propofol and alfentanil
produce higher plasma
levels of alfentanil
than expected. cns depressants
cause additive CNS depression
936 sec. Duration:
610 min. Distribution:
Highly lipophilic, crosses placenta, excreted in breast milk. Metabolism:
Extensively in the liver (CYP 2B6, 2C9). Elimination:
Approximately 88% of the dose is recovered in the urine as metabolites. Half-Life:
Assessment & Drug Effects
- Monitor hemodynamic status and assess for dose-related hypotension.
- Take seizure precautions. Tonic-clonic seizures have occurred following general anesthesia with propofol.
- Be alert to the potential for drug induced excitation (e.g., twitching, tremor, hyperclonus) and take appropriate safety
- Provide comfort measures; pain at the injection site is quite common especially when small veins are used.