China
Africa
Explore chapters and articles related to this topic
Sedation and analgesia
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Essentials of Anesthesia for Neurotrauma, 2018
Paola Cristina Volpi, Barbara Cambiaghi, Giuseppe Citerio
Propofol may be related to a rare but fatal syndrome called propofol infusion syndrome (PRIS) (see the later section under “PRIS”). Another side effect is that propofol’s vehicle is a lipid emulsion, and this can cause deep changes in albumin levels and disorders in fat metabolism that result in hypertriglyceridemia. For the same reason, the lipid emulsion in which propofol is carried includes additives containing soy proteins and egg yolk, which may provoke serious allergic reactions.
Anesthetic agents: Intravenous
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Manual of Neuroanesthesia, 2017
The clinically recommended dosage and pharmacokinetics of propofol are summarized in Table 19.2. The induction dose of propofol in a healthy individual is 1.5–2.5 mg/kg. Because of its short half-life, propofol can also be used as total intravenous anesthesia in maintenance of anesthesia. The maintenance dose of propofol in patients <55 years is 0.1–0.2 mg/kg/min and in patients >55 years, it is 0.05–0.1 mg/kg. Recovery after propofol infusion or multiple doses is much faster than that after barbiturates.11 In patients receiving propofol for prolonged duration, there is increased risk of developing “propofol infusion syndrome,” which is a rare medical condition. It usually develops if infusion is continued for more than 48 h at a dose of 4 mg/kg/h.12 This potentially lethal metabolic derangement has been more commonly found in children and critically ill patients on prolonged infusion of high-dose substance in combination with catecholamines or corticosteroids.13 The signs and symptoms of propofol infusion syndrome include rhabdomyolysis, metabolic acidosis, cardiac failure, and renal failure.12,14,15
Paper 2 Answers
Published in James Day, Amy Thomson, Tamsin McAllister, Nawal Bahal, Get Through, 2014
James Day, Amy Thomson, Tamsin McAllister, Nawal Bahal
Propofol is not safe for use in high-dose prolonged infusions due to the risk of propofol infusion syndrome. This is a syndrome of metabolic acidosis, rhabdomyolysis, hepatomegaly, hypertriglyceridaemia, renal and hepatic failure and is often fatal. Risk factors include high dose infusion over long periods (>4 mg·kg−1·hr−1 for more than 24 hours) and glucocorticoid use.
GABA(A) receptor-targeted drug development -New perspectives in perioperative anesthesia
Published in Expert Opinion on Drug Discovery, 2019
Bernd Antkowiak, Gerhard Rammes
Propofol is the most frequently administered agent for induction and maintenance of sedation and anesthesia [7]. It was discovered in 1977 and approved by the Food and Drug Administration for usage in the United States in 1989 [9]. Propofol is on the World Health Organization’s List of Essential Medicines since 2016. The drug binds to more than two allosteric sites on αβγ-GABAA receptors [21,22]. A knock-in mutation in the β3-subunit largely reduced the hypnotic action of the drug in mice, providing evidence that GABAA receptors are the most important molecular targets for propofol [23]. Propofol is a fat-soluble drug that is highly bound to serum albumin. In humans the percentage of unbound propofol is only 0.98%[24]. The free concentration of propofol to cause anesthesia was estimated to be about 1.2 μmol/L [25]. Its use is associated with several adverse effects. Due to its hydrophobic nature, propofol is solubilized in lipid solutions. If vials are open and exposed to the air, the risk of bacterial contamination is high [26]. Propofol commonly causes pain upon injection [27] and dose-dependent cardiovascular [28] and respiratory depression [29]. Further disadvantages include emulsion instability [30] and hyperlipidemia [31]. Administration for prolonged sedation in the intensive care unit can lead to the development of the propofol-infusion syndrome, a serious complication characterized by acute refractory bradycardia [32].
The role of the clinical laboratory in diagnosing acid–base disorders
Published in Critical Reviews in Clinical Laboratory Sciences, 2019
Typical symptoms of propofol infusion syndrome are metabolic acidosis, dysrhythmias, rhabdomyolysis, and lipemic plasma. Propofol is a short-acting intravenously administered anesthetic agent widely used for sedation or anesthesia. Propofol may cause a high osmolal and high AG metabolic acidosis in rare cases when a high dose (>4 mg/kg/h) is used over a longer period of time. The urine color may become white [190], pink [191], or green [192].