Propofol

Background

1. an ultrashort-acting sedative alkylphenol derivative that induces deep sedation
2. rapid onset (90-100 seconds) and short duration (2-8 minute half-life)

Contraindications

1. allergy to soy or eggs
2. hypotension
3. aortic stenosis

Higher Risk

1. Patients >55 years old
2. Debilitated patients
3. Patients with significant underlying illness (i.e. ASA physical status score III or IV)

^Optimize volume status before administration

Side Effects

1. Respiratory depression
2. Transient hypotension
3. Pain at injection site (inject lidocaine IV first)

Dose

1. induction = 1mg/kg IV, followed by 0.5mg/kg every 2-3 minutes as needed
2. Small incremental doses (10-30mg) can slowly be administered to effect

Adjunctive medications

1. fentanyl or morphine (propofol does not provide analgesia)
2. NS for transient hypotension
3. Lidocaine flush (to reduce injection pain)

Pediatric Population

1. Safe for procedural sedation in pediatric patients. Same dosing.