Adult Dosing
Anesthesia induction
- Adults < 55 yrs:
- 2-2.5 mg/kg IV given as 40 mg q10 sec until induction achieved
- Elderly, debilitated, or ASA-PS III or IV Patients:
- 1-1.5 mg/kg IV given as 20 mg q10 sec until induction achieved
- Neurosurgical patients:
- 1-2 mg/kg IV given as 20 mg q10 sec until induction achieved
- Cardiac anesthesia:
- 0.5-1.5 mg/kg IV given as 20 mg q10 sec until induction achieved
Maintenance of general anesthesia
- Adults < 55 yrs:
- 0.1-0.2 mg/kg/min IV; Alt: 25-50 mg IV PRN
- Avoid prolonged or excessive use
- Elderly, Debilitated, or ASA-PS III or IV Patients:
- 0.05-0.1 mg/kg/min IV; avoid prolonged or excessive use
- Neurosurgical Patients:
- 0.1-0.2 mg/kg/min IV; avoid prolonged or excessive use
- Cardiac Anesthesia:
- 0.1-0.15 mg/kg/min IV; avoid prolonged or excessive use
- Decrease dose to 0.05-0.1 mg/kg/min IV if used as secondary agent
Initiation of MAC Sedation
- 100-150 mcg/kg/min IV x 3-5 mins; Alt: 50 mcg/kg IV x 1 over 3-5 mins
Maintenance of MAC Sedation
- 25-75 mcg/kg/min IV
- Alt: 10-20 mg IV PRN; do not give bolus doses and reduce dose 20% in elderly, debilitated, neurosurgical, or ASA P3-P4 pts; avoid prolonged or excessive use
Intensive Care Unit (ICU) sedation
- Initial: 5 mcg/kg/min IV x 5 mins, then increase 5-10 mcg/kg/min q5-10 mins PRN; avoid prolonged or excessive use. Max: 50 mcg/kg/min IV
Status Epilepticus [Non-FDA Approved]
- Loading dose: 2 mg/kg, followed by continuous infusion 1–10 mg/kg/hr (as limited by hypotension – common range 1-3 mg/kg/hr)
Pediatric Dosing
Induction of general anesthesia
- 3-16 yrs: 2.5-3.5 mg/kg IV x 1 over 20-30 secs
Maintenance of general anesthesia
- 2 months-16 yrs: 0.125-0.3 mg/kg/min IV; avoid prolonged or excessive use
Status Epilepticus [Non-FDA Approved]
- Loading dose 1-2 mg/kg, followed by continuous infusion 2-4 mg/kg/hr
[Outline]
See Supplemental Patient Information
- Therapy may cause fatal and life threatening anaphylactic and anaphylactoid reactions
- Therapy should be administered only by persons trained in the administration of general anesthesia and not involved in the conduct of the surgical/diagnostic procedure for general anesthesia or monitored anesthesia care (MAC) sedation
- Continuously monitor sedated patients and make facilities immediately available such as maintenance of a patent airway, providing artificial ventilation, administering supplemental oxygen, and instituting cardiovascular resuscitation
- Closely monitor patients for early signs of hypotension, bradycardia, apnea, airway obstruction, and/or oxygen desaturation
- Therapy is associated with Infusion Syndrome which may result in death
- Abrupt withdrawal of drug may result in rapid awakening, associated anxiety, agitation, and resistance to mechanical ventilation
- Do not coadminister with the same IV catheter as blood or plasma as compatibility is unknown
- While administering, use aseptic technique to avoid microbial contamination, as it may lead to fever, infection, sepsis, other life-threatening illness, and death
- In elderly patients, use lower induction dose and slower maintainance rate of administration
- Cautiously administer in patients with disorders of lipid metabolism such as primary hyperlipoproteinemia, diabetic hyperlipemia, and pancreatitis
- There is a risk of developing seizures during the recovery phase in epileptic patients
- Administration of therapy may result in development of phlebitis or thrombosis
Cautions: Use cautiously in
- Sepsis
- ASA-PS III-IV
- Elderly or debilitated patients
- Hypertriglyceridemia
- Pancreatitis
- Burns
- Increased ICP
- Impaired cerebral circulation
- Recent fluid shifts
- Hemodynamically unstable
- Seizure disorder
- Diarrhea
- Hyperlipidemia
Supplemental Patient Information
- Do not engage in activities requiring mental alertness, such as operating a motor vehicle or hazardous machinery, or signing legal documents
Pregnancy Category:B
Breastfeeding: Safe. Amounts of propofol in milk are very small and the drug is not expected to be absorbed by the infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 21 April 2011). According to manufacturer data, therapy is not recommended for use in nursing mothers.
3 years of age)
