Question

List the contraindications and precautions for use of propofol, the prototype intravenous anesthetic

Due to its formulation, what special precautions are necessary when administering propofol?

Answer 1

Propofol: It is used as an iv hypnotic agent in the induction and maintenance of general anesthesia and sedation.

Contraindications and precautions include:

(1). Hypersensitivity: propofol emulsion contain soyabean oil amd egg yolk phospholipids,so this drug should not be used in patient with egg hypersensitivity or soya hypersensitivity.

(2). Sepsis: Failure to use asceptic technique while handling propofol emulsion lead to growth of microorganisms. So never use contamination is suspected.

(3). Propofol should be used in cautiously in patient with cardiac disease, dehydration, heart failure, hypotension, hypovolemia, pulmonary disease.

(4). Should be used in caution with hyperlipidemia, hyperlipoprotenemia as propofol will aggravate this disorders of lipid metabolism.

(5). Geriatric peoples are more sensitive to propofol.

(6). Contraindicated in patient with cerebrovascular accident, seizure disorders, increased intracranial pressure.

(7). To be used cautiously in children, neonates, infants as propofol can cause negative effect on brain development.

(8). Contraindicated in breast-feeding women as propofol will excret in human milk.

(9). Used cautiously in renal impairment,renal failure and renal diseases.

(10). Abrupt discontinuation: sudden discontinuation is not recommended while using propofol infusion. Maintain a light sedation level throughout the weaning process until 15 minutes before extubation.

(11). Should be used cautiously in patient with diarrhoea and Burns. These patients will have zinc deficiency. Propofol will aggravate this. So zinc supplimentation should be provided during propofol use.

(12). After propofol administration, patient should avoid driving and operating maschine.

While administering propofole patient should be closely monitored for level of consciousness, early sings of hypotension, bradycardia, apnea, airway obstruction, and desaturation.

Appropriate airway management equipment should be readily available.