Only intravenously.
Propofol Kabi 20 mg / ml can be used only by anesthetists in hospitals or adequately equipped outpatient departments, as well as in intensive care units.
When administering Propofol Kabi 20 mg / ml, the doctor should have the equipment usually used for general anesthesia, including cardiovascular function monitoring (ECG, pulse oximetry) and resuscitation facilities. The dose of Propofol Kabi 20 mg / ml should be selected individually, taking into account the patient's response and premedication.
As a rule, when using the drug, additional administration of analgesic drugs is required.
General anesthesia in adults
Introduction to general anesthesia:
When administered in a general anesthetic, Propofol Kabi 20 mg / mL should be administered fractional (approximately 20-40 mg of propofol every 10 seconds), until the appearance of clinical signs of anesthesia.
The usual dose for adults under the age of 55 years is 1.5-2.5 mg / kg body weight.
In older patients and in patients with grade III and IV severity, the classification by the American Society of Anesthesiologists (ASA), especially with impaired function of the heart, the required dose is usually lower.
The total dose of Propofol Cabi 20 mg / ml can be reduced to a minimum of 1 mg / kg.
A slower administration of Propofol Kabi 20 mg / ml is required: approximately 1 ml (20 mg of propofol) every 10 seconds.
Maintaining anesthesia
To maintain general anesthesia, Propofol Kabi 20 mg / ml is injected continuously in droplets or repeatedly in the form of boluses.
For maintenance anesthesia propofol apply in a dose of 4-12 mg / kg of weight.
With less severe surgical interventions, for example, minimally invasive, a maintenance dose can be reduced to about 4 mg / kg body weight / hour.
In elderly, patients with unstable general condition, patients with impaired cardiac function or hypovolemia and patients with grade III-IV severity, the ASA classification can be reduced even more, given the severity of the condition and the technique of anesthesia.
General anesthesia in children older than 3 years
Propofol Kabi 20 mg / ml is not recommended for general anesthesia in children under 3 years of age, since the concentration of 20 mg / ml of the emulsion is difficult to titrate, and small children need a very small amount of the drug. For children aged 1 month to 3 years, it is recommended to use Propofol Kabi 10 mg / ml, with a dose should be less than 100 mg / h.
Introduction to general anesthesia
When administered to general anesthesia, slow titration of the Propofol Kabi dose of 20 mg / ml is recommended until the appearance of clinical signs of general anesthesia.
The dose is chosen taking into account the age and / or body weight.
In children over the age of 8, the dose necessary for administration to general anesthesia is approximately 2.5 mg / kg body weight.
In young children, the dose may be higher. The drug is started with a dose of 3 mg / kg. If necessary, additional doses of 1 mg / kg may be administered.
Children from high-risk groups (III-IV severity of ASA classification) are recommended to have lower doses.
Maintaining anesthesia
To maintain general anesthesia, a continuous infusion of 9-15 mg / kg / h is administered. There are no data on repeated injections of propofol to maintain general anesthesia in children.
The dose is selected individually. It is necessary to pay special attention to the adequacy of anesthesia.
Sedation in adults in intensive care units
For sedation during mechanical ventilation in the intensive care units, Propofol Kabi 20 mg / mL is recommended to be administered by continuous infusion. The dose is selected taking into account the necessary depth of sedation. Usually adequate sedation can be achieved with a propofol administration rate of 0.3-4.0 mg / kg / h. Increase the rate of administration of more than 4.0 mg / kg / h is not recommended.
Propofol Kabi 20 mg / ml should not be used for sedation in intensive care units in patients aged 16 years and under.
Methods of administration
For intravenous administration.
Propofol Cabi 20 mg / ml is administered intravenously undiluted, as a continuous infusion.
Propofol Cabi 20 mg / ml can not be used for repeated bolus injection in order to maintain anesthesia.
When administering Propofol Kabi 20 mg / ml, it is recommended to control the infusion rate with a burette, a syringe or IV infusion pump.
The vial should be shaken before the introduction.
Apply only a homogeneous product from an intact vial.
Before use, the rubber membrane should be treated with alcohol.
Since Propofol Cabi 20 mg / ml is a fat emulsion that does not contain preservatives and does not have antimicrobial activity, the preparation can serve as a favorable medium for rapid growth of microorganisms.
Emulsion should be typed in a sterile syringe or dropper immediately after opening the vial. Introduction must begin without delay.
During the entire period of administration of Propofol Kabi 20 mg / ml, the rules of aseptic work with the drug and the system for parenteral infusion should be observed.
Other drugs or solutions that need to be administered concurrently with the administration of Propofol Cabi 20 mg / ml should be injected into the dropper through a Y-shaped connector or valve.
Propofol Cabi 20 mg / ml should not be mixed with other solutions for intravenous administration. However, through the cannula of a dropper, you can simultaneously inject 5% glucose solution, 0.9% or 0.18% sodium chloride solution and 4% glucose solution.
Propofol Kabi 20 mg / ml can not be administered via an antibacterial filter.
Propofol Cabi 20 mg / ml and other infusion systems containing propofol, are intended only for single use and only for one patient individually.
Any residues of the Propofol Kabi emulsion 20 mg / ml should be disposed of after use.
As with other fat emulsions, the duration of administration of Propofol Cabi 20 mg / ml with a single infusion system should not exceed 12 hours. After 12 hours, the infusion system and the tank with Propofol Kabi 20 mg / ml should be replaced.
To reduce pain when injected, the infusion should be injected into a larger vein, or a solution of lidocaine can be administered just before the infusion of Propofol Kabi 20 mg / ml.
Muscle relaxants, such as atracurium and myovacury, can be administered via the same catheter only after jet washing.
Duration of application should not exceed 7 days.