Propofol
Trade names:
Diprivan
Class: short-acting Intravenous anesthetic
Pregnancy:
(Category B) Action:
Produces sedation/hypnosis rapidly (within 40
sec) and smoothly with minimal excitation; decreases IOP and systemic vascular
resistance; rarely is associated with malignant hyperthermia and histamine
release; suppresses cardiac output and respiratory drive.
Uses:
Induction and maintenance of anesthesia
in adults; induction anesthesia in children at least 3 yr of age; maintenance
anesthesia in children at least 2 mo of age; initiation and maintenance of
monitored anesthesia care sedation in adults; sedation in intubated or
respiratory-controlled adult ICU patients.
Dose:
Induction of anesthesia, by intravenous
injection or infusion, 1.5–2.5 mg/kg (less in those over 55 years) at a rate of
20–40 mg every 10 seconds; CHILD over 1 month, administer slowly until response
(usual dose in child over 8 years 2.5 mg/kg, may need more in younger child,
Maintenance of anesthesia, by intravenous
injection, 25–50 mg repeated according to response or by intravenous infusion,
4–12 mg/kg/hour; CHILD over 3 years, by intravenous injection or infusion, 9–15
mg/kg/hour
Sedation in
intensive care, by intravenous infusion, adult over 17 years, 0.3–4 mg/kg/hour
Contraindications:
Situations in which general
anesthesia or sedation are contraindicated.
Side effects:
ý difficulty
breathing, wheezing, swelling of the throat
ý fast heartbeat, palpitations
ý lightheadedness or fainting spells
ý numbness or tingling in the hands or feet
ý seizure (convulsion)
ý skin rash, flushing (redness), or itching
ý swelling or extreme pain at the injection site
ý uncontrollable muscle spasm Nursing considerations:
ý Should be administered only by personnel who are trained in
administration of general anesthesia and familiar with drug.
ý Administer only in settings in which resuscitation equipment is
immediately available.
ý Shake well before use. Do not use if there is evidence of
separation of phases of emulsion.
ý Maintain strict aseptic technique in handling; rapid growth of
organisms may occur if contaminated.
ý Dilute with dextrose 5% injection, but do not dilute to
concentration less than 2 mg/mL.
Drug is compatible with dextrose 5%; lactated Ringer's
injection; lactated Ringer's and
dextrose 5%
injection; dextrose 5% and sodium chloride 0.45% injection; dextrose 5% and
sodium chloride 0.2% Injection.
ý Minimize pain associated with administration by infusing into
larger veins.
ý Discard any unused portions of drug or solution at end of
anesthetic procedure; do not keep for more than 6 h.
ý In ICU sedation discard after 12 h if administered directly from
vial or after 6 h if transferred to syringe or other container.
