GuidelinesOther guideline
Infusion: Propofol
PROPOFOL INFUSION
| Trade names: | Presentation and strength: |
| Diprivan | 10mg/ml (1%) 20ml ampoules. 20mg/ml (2%) in 50ml vials. |
| Cautions: see SAMF. Beware two separate strengths – source of drug error. Both strengths cause irritation (burning) when administered through peripheral veins. Propofol infusions must be administered with strict aseptic technique, and should be completed within 6 hours of opening the ampoule, as propofol is a preservative-free bacterial culture medium. Propofol can cause severe hypotension in the elderly, in dehydrated patients or those otherwise haemodynamically unstable. Doses may need to be doubled in children, or halved in the elderly. Propofol is incompatible with atracurium. Propofol should be used with great caution by those unfamiliar with the drug. | |
| Loading dose: | |
| Adult: IV anaesthetic induction: 1.5 to 2.5mg/kg. | Paediatric: IV anaesthetic induction: up to 4mg/kg. (150 to 200% or more of adult dose in mg/kg). |
| Commonly for 70kg adult: 120 to 150mg slow IV bolus. | Neonatal: Not recommended. |
| Constant infusion: | |
| Adult dosage range: Maintenance of anaesthesia: 4 to 12mg/kg/hr. Sedation in ICU: 1 to 3mg/kg/hr. | Paediatric dosage range: Risk of propofol infusion syndrome. |
| Neonatal dosage range: Not recommended. | |
| Regime for 70kg adult: | Regime for paediatrics: |
| Mixture: 1% solution = 10mg/ml. 2% solution = 20mg/ml. | Mixture: N/A |
| Rate: Range: 70 to 210mg/hr. 1% solution: 7 to 20ml/hr. 2% solution: 3.5 to 10ml/hr. | Rate: N/A |
| Alternative adult regime: | Alternative paediatric regime: |
| Mixture: (For administration through peripheral vein) 5mg/ml = 1000mg in 200ml saline. Add 100ml of 1% solution to 100ml saline or 50ml of 2% solution to 150ml saline. | Mixture: N/A |
| Rate: 14 to 48ml/hr. | Rate: N/A |
| Additional notes: Total Intravenous Anaesthesia (TIVA) regimes are beyond the scope of this protocol. Propofol 2% solution may not be available in Western Cape district-level hospitals - use propofol 1%. Propofol may be used in the management of status epilepticus. | |