Propoven 2% Infusion

Indications

• Induction of general anesthesia
• Maintenance of general anesthesia
• Sedation for mechanically ventilated adults in the intensive care unit
• Sedation for diagnostic and therapeutic procedures

Dosage

Children: Refer to the relevant pediatric guidelines or the BNF for Children for appropriate dosing.

Adults: Refer to specific clinical guidelines or institutional protocols for dosing information.

Mechanism of action

Propofol primarily acts as a positive allosteric modulator of the GABA-A receptor, enhancing the inhibitory effects of gamma-aminobutyric acid (GABA). This results in increased chloride ion conductance, leading to hyperpolarization of neuronal membranes and subsequent sedation and anesthesia. Additionally, propofol may have effects on other neurotransmitter systems, contributing to its anesthetic properties.

Pharmacodynamics

The pharmacodynamic effects of propofol include rapid sedation, decreased consciousness, and muscle relaxation. The drug exhibits dose-dependent effects, with lower doses leading to sedation and higher doses resulting in general anesthesia. Propofol is known for its antiemetic properties, reducing the incidence of postoperative nausea and vomiting.

Pharmacokinetics

Propofol has a rapid onset of action, typically within 30 seconds after intravenous administration, due to its high lipid solubility and rapid distribution to the brain. The drug is metabolized primarily by the liver through conjugation and oxidative metabolism, resulting in inactive metabolites. Elimination half-life is approximately 1 to 3 hours, though its effects may be prolonged in patients with compromised liver function. Propofol is excreted mainly in urine as metabolites, with less than 1% of the drug being excreted unchanged.

Contra-indications

• Hypersensitivity to propofol or any of its components
• Patients with a history of soybean or egg allergy (due to the formulation ingredients)

Adverse effects

• Hypotension
• Respiratory depression
• Apnea
• Bradycardia
• Injection site pain
• Propofol infusion syndrome (especially with prolonged use in high doses)
• Nausea and vomiting

Interactions

• Other central nervous system depressants (e.g., benzodiazepines, opioids) may enhance the effects of propofol
• Drugs that affect hepatic metabolism may alter propofol clearance
• Caution when used with other anesthetics or sedatives

Precautions

• Use cautiously in patients with compromised respiratory function
• Monitor cardiovascular status closely during administration
• Ensure resuscitation equipment is available due to the risk of respiratory depression and hypotension

Pregnancy

Propofol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It crosses the placenta.

Breast-feeding

Propofol is excreted in human milk. Caution should be exercised when administered to nursing mothers.

Storage

Store at room temperature, protect from light. Discard any unused portions; do not store for prolonged periods after opening.

Formulations

• Intravenous emulsion 10 mg/mL