Propofol

Sedation in ICU setting in children <16 years.

Patient with lipid metabolism disorders such as hypertriglyceridaemia or pancreatitis, or risk of fat overload; cardiac impairment; pulmonary insufficiency or respiratory depression; increased intracranial pressure or impaired cerebral circulation; hypovolaemia, unstable haemodynamics, abnormal low vascular tone (e.g. sepsis); risk factors for PRIS (e.g. decreased oxygen delivery, sepsis, serious cerebral injury). Patient predisposed to zinc deficiency (e.g. diarrhoea, major sepsis, burns). ASA grade 3 or 4, debilitated and epileptic patient. Renal and hepatic impairment. Children and elderly. Pregnancy and lactation. . Avoid abrupt discontinuation; taper infusion dose to prevent withdrawal (for prolonged infusions). Not recommended for obstetric anaesthesia including caesarean section deliveries. Patient Counselling This drug may impair ability to drive or operate machinery. Monitoring Parameters Monitor cardiac input, blood pressure, oxygen saturation (during monitored anaesthesia care sedation); ABG (prolonged infusions). Monitor signs and symptoms of PRIS. Monitor serum triglycerides prior to initiation of therapy for ICU sedation and every 3-7 days thereafter; zinc level after 5 days of treatment.

Significant: ECG effects (e.g. QT shortening/prolongation), hypertriglyceridaemia, hypotension, injection-site reaction, perioperative myoclonus (e.g. convulsions, opisthotonos), involuntary movement, Rarely, postoperative unconsciousness with or without an increase in muscle tone, anaphylaxis, hypersensitivity reactions. Cardiac disorders: Cardiac arrhythmia, low cardiac output, tachycardia. Gastrointestinal disorders: Nausea and vomiting. Metabolism and nutrition disorders: Respiratory acidosis. Nervous system disorders: Headache. Psychiatric disorders: Depression, confusion. Respiratory, thoracic and mediastinal disorders: Cough, laryngospasm. Skin and subcutaneous tissue disorders: Rash, pruritus. Vascular disorders: Hypertension.
Potentially Fatal: Propofol-related infusion syndrome (PRIS) (e.g. lactic acidosis, hyperlipidaemia, hyperkalaemia, rhabdomyolysis). Abuse and dependence.

Additive sedative/anaesthetic and cardiorespiratory depressant effect with other CNS depressants. Profound hypotension with rifampicin. Valproate may increase serum levels of propofol.

Anaesthetics- local & general

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