Propofol (Propofol)

Intravenously.

Usually, propofol together with analgesics.

Lower doses may be required in cases where general anesthesia is used as a supplement to regional anesthesia.

Adults

Induction of general anesthesia

It is used by slow bolus injections or infusion. Regardless of whether premedication was or was not conducted, the administration of propofol is recommended to be titrated (bolus injections or infusion of approximately 40 mg every 10 seconds - for the average adult patient in satisfactory condition), depending on the patient's response before the appearance of clinical signs of anesthesia.For most adult patients under 55 years of age, the average dose of propofol is 1.5-2.5 mg / kg body weight. The required total dose can be reduced using lower administration rates (20-50 mg / min). For patients older than this age, usually a lower dose is required. Patients 3 and 4 grades on a scale ASA (American Society of Anesthesiologist), administration should be performed at a lower rate (approximately 20 mg every 10 seconds).

Maintaining general anesthesia

The required depth of anesthesia can be maintained either by continuous infusion or by repeated bolus injections of propofol.

Continuous infusion: the necessary rate of administration varies considerably depending on the individual characteristics of the patients. Typically, a rate of between 4-12 mg / kg / h ensures adequate anesthesia.

Repeated bolus injections: The administration of increasing doses from 25 mg to 50 mg, depending on the clinical need, is used.

Ensuring a sedative effect during intensive care

It is recommended to use it through continuous infusion. The rate of infusion should be adjusted to take into account the necessary depth of sedation.A dose of 0.3 to 4.0 mg / kg / h should ensure a satisfactory sedation.

Providing sedative effect with preservation of consciousness in patients during surgical and diagnostic procedures

The rate of administration and dose should be selected individually depending on the clinical response of the patient. For most patients, 0.5-1 mg / kg body weight is required for 1-5 minutes for the onset of sedation. To maintain a sedative effect, the infusion rate should be adjusted according to the required depth of sedation. For most patients, a speed of 1.5-4.5 mg / kg / h is required. If a rapid increase in the depth of sedation is required, bolus administration of 10-20 mg of propofol may be used as an adjunct to the infusion. For patients of grades 3 and 4 on a scale ASA it may be necessary to reduce the dose and rate of administration.

Elderly patients

Older patients require lower doses for anesthesia. A reduced dose should be administered at a lower rate than usual and titrated according to the patient's response.When used to maintain anesthesia or to provide a sedative effect, the infusion rate or "target concentration" of the drug should be reduced. For patients of grades 3 and 4 on a scale ASA a further reduction in dose and rate of administration may be required. To avoid oppression of the heart and respiratory system, elderly patients are not recommended for rapid bolus administration (single or repeated).

Children

Not applicable in children under 3 years.

Induction of general anesthesia

In order to ensure the induction of anesthesia in children propofol it is recommended to administer slowly before the appearance of clinical signs of anesthesia. The dose should be adjusted according to the age and / or weight of the child. For most children over the age of 8 years, approximately 2.5 mg / kg body weight is required to induce anesthesia. For children younger than this age, the required dose may be higher. A lower dose is recommended for children of grades 3 and 4 on a scale ASA.

Maintaining general anesthesia

Maintenance of anesthesia is achieved by continuous infusion, or by repeated bolus injections, required to maintain the necessary depth of anesthesia.The required rate of administration differs in different patients. Usually, satisfactory anesthesia is provided at an infusion rate of 9-15 mg / kg / h.

Ensuring a sedative effect with preservation of consciousness during surgical and diagnostic procedures

Use in children regardless of age for this indication is not recommended.

Ensuring a sedative effect during intensive care

Use in children regardless of age for this indication is not recommended.

Introduction

Propofol can be administered without dilution, only using a perfusor or infusomat to ensure control of the rate of administration.

It can also be used diluted with only 5% dextrose solution, intended for intravenous administration. A solution, the dilution of which should not exceed a ratio of 1: 5 (2 mg propofol / ml), should be prepared immediately before use. The mixture remains stable for 6 hours.

Propofol can be administered via a tee with a valve near the injection site, concomitantly with the administration of 5% dextrose solution for intravenous administration, 0.9% sodium chloride solution for intravenous administration or 4% dextrose solution with 0.18% sodium chloride solution for intravenous administration.

Propofol can be pre-mixed with alfentanil for injection containing 500 μg / ml of alfentanil in a volume ratio of 20: 1 to 50: 1. Mixtures should be prepared using sterile equipment, and applied within 6 hours after preparation.

To reduce pain at the start of the injection, the induction dose of Propofol immediately before administration can be mixed with lidocaine for injection in the proportion of 20 parts of Propofol and up to one part of 0.5% or 1% of lidocaine.

Propofol and co-administration in combination with other drugs