Propofol (Intravenous Anesthetic ) Drug Review
- It is available as 1% and 2% milky white colored solution which is compatible with dextrose.
- It contains soyabean oil so the injection is always painful.
- Xylocard 1 % is added to the mixture of propofol to reduce the pain at the injection site .
- The Propofol mixture contains:
- a) 1% propofol
- b) 10% soyabean oil
- c) 2.25 glycerol
- d) 1.2% egg phosphatide
- e) Edeate
- f) 1.2 % egg phosphate
- g) 0.005% disodium
- The chemical formula of Propofol is Alkyl phenol 2,6 diisopropyl phenol
- PH: 7
- Pka: 10.76
- It is availabe as milky white solution.
MECHANISM OF ACTION (MOA)
- It acts by binding on the sub unit of GABA receptor .
- It decreases the release of acetylcholine in hippocampus and prefrontal lobe .
DRUGS DOSE AND FEATURES
- Dose : 2 mg per kg body weight
- Onset of action : 15 sec
- Duration effect of unconsciousness: 2-8 min
- Half life : 2-3 hours
EFFECTS ON THE DIFFERENT SYSTEMS
CARDIOVASCULAR SYSTEM (CVS)
- Bradycardia is more common
- Propofol causes peripheral vasodilatation more than Thiopentone sodium.
- It does not causes Tachycardia.
RESPIRATORY SYSTEM (RS)
- Propofol is a respiratory depressant .
- Propofol is also a bronchodilator .
- It depresses the reflex of upper airway.
- It is the drug of choice for the day care surgeries.
CENTRAL NERVOUS SYSTEM (CNS)
- It is a anticonvulsant .
- It causes sedation , amnesia and hypnosis.
- It decreases intra cranial pressure (ICP)
- It is also an anti emetic
- It does not causes analgesia .
- It causes Apnea commonly and acts for longer duration than the Thiopentone .
- Recovery is faster than the thiopentone.
- It can cause hallucinations and sexual fantasies after induction
COMPLICATIONS OF PROPOFOL
- Propofol Infusion syndrome(PIS)
- Pain at the injection site
1.Propofol Infusion syndrome
- Propofol infusion syndrome usually occurs in children’s., It is a life threatening condition .
- PIS may cause
- – Cardiomayopathy
- – Skeletal myopathy
- – Hepatomegaly
- – Failure of free fatty acid metabolism
- – Hyperkalemia
- – Acute cardiac failure
- – It can also cause pancreatities in adult.
2.Pain at the injection site
- Propofol causes pain at the injection site.
- The pain can be reduced by adding 1% Xylocard (1ml) per 10 ml of propofol solution .
- Now a days propofol comes along with the local anesthetic added in it eg. Spiva 2%
- To avoid the complications larger veins should be used while injecting the drug .
- The reason for the pain is Kallikrein pathway is activated.
Propofol is the drug (IV anesthetic) of choice for the following
- For the day care surgeries.
- Malignant hyperthermia.
- Sedation in the ICU
- For performing minor sedation cases like endoscopy
- Renal failure.