Propofol-Lipuro

Propofol

Induction & maintenance of general anaesth in adults & childn >1 mth; sedation of ventilated ICU patients >16 yr; sedation for diagnostic & surgical procedures, alone or in combination w/ local or regional anaesth in adults & childn >1 mth.

IV General anaesth Adult Induction Titrate (20-40 mg every 10 sec) against response until onset of anaesth. Usually 1.5-2.5 mg/kg in adult <55 yr. 200 mg/20 mL amp Total dose may be reduced to min 1 mg/kg or less in older patient & in patient w/ ASA grades III & IV, especially w/ impaired cardiac function. 500 mg/50 mL vial Total dose may be reduced to min of 1 mg/kg in adult >55 yr, & in patient w/ ASA grades III & IV, especially w/ impaired cardiac function. Maintenance Via repeat bolus inj: Increments of 25-50 mg according to clinical requirement. Via continuous infusion: 4-12 mg/kg/hr. Childn >1 mth Induction Titrate slowly against response until onset of anaesth. Usually 2.5 mg/kg in patient >8 yr. Dose requirements may be higher (2.5-4 mg/kg) in younger childn 1 mth to 3 yr. Maintenance Via continuous infusion: 9-15 mg/kg/hr. Dose requirements may be higher in childn 1 mth to 3 yr. Lower dose is recommended for ASA III & IV patient. Sedation in ICU 0.3-4 mg/kg/hr via continuous infusion. Sedation for diagnostic & surgical procedures Adult Usually 0.5-1 mg/kg over 1-5 min. Maintenance Titrate to the desired level of sedation, usually 1.5-4.5 mg/kg/hr. May be supplemented by bolus administration of 10-20 mg if a rapid increase of the depth of sedation is required. Lower doses & reduced rate of administration may be required in patient >55 yr & patient of ASA grades III & IV. Childn >1 mth Usually 1-2 mg/kg. Maintenance Titrate to the desired level of sedation, usually 1.5-9 mg/kg/hr. May be supplemented by bolus administration of up to 1 mg/kg if a rapid increase of the depth of sedation is required.

Hypersensitivity to propofol, soya, peanut, or any of the excipients. Childn ≤16 yr for sedation in ICU. 200 mg/20 mL amp Childn <1 mth for induction & maintenance of anaesth.

Administration w/o airway care may result in fatal resp complications. Caution in patients w/ cardiac, resp, renal or hepatic impairment, hypovolemia; debilitated patients; epileptic patients; patients w/ disorders of fat metabolism & other conditions where lipid emulsions must be used cautiously. Reports of bradycardia & asystole. Continually monitor patients for early signs of hypotension, airway obstruction & oxygen desaturation when propofol is administered for conscious sedation, for surgical & diagnostic procedures. Involuntary patient movements may occur when used for sedation during operative procedures. Reports of propofol infusion syndrome in ICU patients (combinations of the following: metabolic acidosis, rhabdomyolysis, hyperkalaemia, hepatomegaly, renal failure, hyperlipidaemia, cardiac arrhythmia, Brugada-type ECG & rapidly progressive cardiac failure usually unresponsive to inotropic supportive treatment). Monitor blood lipid levels in patients at risk of fat overload. Concomitant use w/ medications which reduces cardiac output. Contains no antimicrobial preservatives; maintain asepsis throughout the infusion period. Performance at skilled tasks (eg, driving & operating machinery) may be impaired for some time after propofol administration. Do not give to pregnant women except when necessary. Can cause neonatal depression. Women should not breastfeed for 24 hr after propofol administration. Not recommended in newborn infants. 200 mg/20 mL amp Patients w/ raised ICP. 500 mg/50 mL vial Patients w/ mitochondrial disease.

Local pain on induction. Headache during recovery phase, bradycardia, hypotension, transient apnoea during induction, nausea & vomiting during recovery phase.

Lower doses of propofol may be required where general anaesth or sedation is used as an adjunct to regional anaesth techniques. 500 mg/50 mL vial Reports of profound hypotension following anaesth techniques induction w/ propofol in patients treated w/ rifampicin. Lower propofol doses may be considered in patients taking valproate.

Anaesthetics - Local & General

N01AX10 - propofol ; Belongs to the class of other general anesthetics.

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