Propofol
Indications
Propofol is a short-acting anaesthetic given into a vein. It is used to start (induce) and maintain general anaesthesia for operations, to provide sedation (a calm, sleepy state) during procedures such as endoscopy, and to sedate patients on breathing machines in intensive care.
How It Works
Propofol increases the effect of GABA, the brain's main calming chemical messenger. This quickly slows brain activity and causes loss of consciousness, usually within a minute of injection. Because it is cleared from the body quickly, people wake up soon after the infusion is stopped, often with less sickness than with some other anaesthetics.
Dosage and Administration
Propofol is given only by an anaesthetist or a trained doctor in a hospital or clinic with full monitoring and breathing support equipment available. The dose is adjusted continuously according to age, weight, health and the depth of sleep needed. It is given as an injection or infusion into a vein. Patients are usually asked not to eat or drink for several hours before, and must not drive or make important decisions for at least 24 hours afterwards.
Interactions
Other medicines that depress the brain and breathing, such as opioid painkillers (for example Fentanyl or Morphine), benzodiazepines (for example Midazolam), other anaesthetics and alcohol, add to its effects, so lower doses are needed. Tell the medical team about all medicines you take.
Contraindications
It should not be used in people with a known allergy to Propofol or to its ingredients (it is made as an emulsion containing soya oil and egg lecithin). It is not used for long-term sedation in intensive care for children under 16.
Side Effects
Pain or burning at the injection site is common. It may cause a drop in blood pressure, slow heartbeat, slowed or paused breathing (managed by the team), involuntary movements, and on waking, headache, nausea or vivid dreams. Rarely, long, high-dose infusions can cause propofol infusion syndrome, a serious condition affecting the heart, muscles and kidneys.
After going home, get urgent medical help if you have breathing difficulty, chest pain, a very fast or irregular heartbeat, severe confusion, dark or reduced urine, muscle pain or signs of an allergic reaction such as rash or swelling.
Pregnancy and Lactation
It may be used in pregnancy, including for caesarean section, when the anaesthetist judges it appropriate. Small amounts pass into breast milk; mothers can usually resume breastfeeding once fully awake, but follow the anaesthetist's advice.
Precautions and Warnings
Tell the team about heart, lung, liver or kidney disease, epilepsy, disorders of fat metabolism, allergies to egg or soya, and any previous reactions to anaesthesia. An adult should take you home and stay with you after day procedures. Propofol has been misused; it must only be used in medical settings.
Overdose
Overdose causes deep unconsciousness, stopped breathing and low blood pressure. It is managed immediately by the medical team with breathing support and fluids.
Therapeutic Class
Intravenous general anaesthetic and sedative.
Storage
Hospital use only. Stored as directed on the pack, usually below 25°C; do not freeze. Shake before use and discard unused emulsion as directed.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.
All brands of Propofol