Propofol is a short-acting, intravenous general anesthetic agent belonging to the alkylphenol class. It is a milky white emulsion used for the induction and maintenance of general anesthesia, procedural sedation, and sedation in intensive care units (ICU). It is characterized by a rapid onset and short duration of action, with a favorable recovery profile and minimal post-operative nausea and vomiting. In India, it is a critical drug in modern anesthesia practice.
Adult: Induction: 1.5 to 2.5 mg/kg IV bolus. Maintenance: 100 to 200 mcg/kg/min IV infusion (6-12 mg/kg/hr). ICU Sedation: 0.3 to 4.0 mg/kg/hr (5-67 mcg/kg/min) IV infusion. Procedural Sedation: 0.5 to 1 mg/kg bolus followed by 25-75 mcg/kg/min infusion.
Note: For IV use only. Use strict aseptic technique. Inspect for particulate matter/discoloration. Do not use if emulsion is separated. Can be administered as a slow IV bolus (over 20-30 seconds for induction) or as a controlled continuous infusion using a syringe or volumetric pump. Flush IV line to prevent pain on injection (can be pre-treated with lidocaine). NEVER administer via the same IV line concurrently with blood or plasma.
Propofol potentiates GABAergic neurotransmission by binding to beta subunits of the GABA-A receptor, increasing the receptor's affinity for GABA. This enhances chloride ion influx, leading to neuronal hyperpolarization and inhibition of synaptic transmission. It also inhibits the NMDA receptor and modulates calcium ion influx through slow calcium channels.
Pregnancy: Category B (US FDA). Should be used during pregnancy only if clearly needed, typically for necessary surgical procedures. Crosses placenta; may cause neonatal depression.
Driving: Patients must be advised not to drive, operate machinery, or make important decisions for at least 24 hours after receiving propofol due to residual sedation and amnesia.
| Benzodiazepines (Midazolam, Diazepam) | Potentiated sedative, hypnotic, and respiratory depressant effects. Dose reduction required. | Major |
| Opioids (Fentanyl, Morphine) | Synergistic increase in sedation, analgesia, and respiratory depression. Profound hypotension and bradycardia possible. | Major |
| Inhaled Anesthetics (Isoflurane, Sevoflurane) | Additive CNS and cardiovascular depressant effects. | Moderate |
| Clonidine | Enhanced hypotensive and bradycardic effects. | Moderate |
| Theophylline | Antagonizes CNS depressant effects of propofol; may require higher doses. | Moderate |
Same composition (Propofol (200mg)), different brands: