Propofol

Summary

Propofol is a drug that is often used as a general anesthetic during surgery, but is also used for its sedative effects in the ICU setting. Notably, the drug can slow down both the respiratory and cardiovascular systems, causing respiratory depression, a low blood pressure, and a slow heart rate. As the nurse, be sure to closely monitor these vital signs and notify the provider if they fall below a normal range.

Key Points

• Propofol (Diprivan)
  • Mechanism
    • Non-barbiturate Sedative
      • Binds to GABA receptors to depress the CNS
    • Administered via IV
  • Clinical Use
    • Sedation / Anesthesia
      • Used to keep ventilated patients sedated
      • Used as part of an anesthetic regimen
  • Side Effects and Adverse Reactions
    • Respiratory depression
      • Closely monitor respiratory rate, which should be at least 12 breaths per minute
    • Cardiovascular depression
      • Hypotension and bradycardia
      • Closely monitor heart rate and blood pressure
    • Increased Risk For Bacterial infection
      • Propofol supports microbial growth
    • Propofol Infusion Syndrome (PRIS)
      • Rare, but extremely dangerous
      • Associated with prolonged high doses
      • Metabolic acidosis, cardiac arrhythmias, hyperkalemia, lipemia, hepatomegaly, acute kidney injury