The Dept of Anaesthesia & Intensive Care, CUHK thanks

for an unrestricted education grant
Intensive Care Nephrology - beyond BASIC courses: London (June), Singapore (July)
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Asian Intensive Care Conference, Hong Kong, November 21-22nd 2013

Intravenous induction agent and sedative with no analgesic properties

Preparation

• 1% emulsion of soyabean oil, glycerol and egg phosphatide
• provides 1.1 kcal/ml
• Diprivan™ contains ethylenediaminetetraacetic acid as a preservative to retard growth of micro-organisms
• generic form contains sodium metabisulfite as the preservative

Pharmacokinetics

• IV administration
• hepatic and extra-hepatic metabolism. Latter results in relatively short duration of action even in patients with hepatic failure
• kinetics not affected by renal disease

Mode of action

Not clear but appears to involve GABA receptors in CNS

Clinical use

• recommended for short term (<24h) sedation in ICU
• propofol bottles, syringes and infusion tubing should be changed every 12 hours because of risk of infection

Adverse effects

• myocardial depression and vasodilation leading to hypotension
• hypertriglyceridaemia and pancreatitis
• pain on injection
• rarely metabolic acidosis, rhabdomyolysis and cardiovascular collapse

Further reading

Liu LL, Gropper MA. Postoperative analgesia and sedation in the adult intensive care unit. A guide to drug selection Drugs, 2003; 63(8):755-67

©Charles Gomersall, May, 2013 unless otherwise stated. The author, editor and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this webpage.
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