The drug is administered intravenously.
Method of application
The preparation can be administered only by specially trained personnel while providing the possibility of immediate carrying out of artificial ventilation, oxygen therapy and resuscitation in full.
Propovan does not contain antimicrobial substances and can serve as a favorable environment for the development of microorganisms. When the sterile syringe or perfusor is filled with Propovan, the aseptic rules should be followed; the drug must be recruited immediately after opening the vial. The introduction should begin immediately. Aseptic conditions must be observed both in relation to Propovan and in the apparatus for administration during the entire period of administration.Drugs or liquids used in combination with Propovan should be administered near the place of administration of Propovan and using the same cannula. Propovan should not be injected through a microbiological filter.
In the event of signs of detachment of the oil phase, the preparation should not be used.
Propovan can be used undiluted using plastic syringes or glass vials for infusions. In cases where Propovan is used undiluted to maintain general anesthesia, it is recommended to always use perfusors or infusomats in order to control the rate of administration.
Propovan can be diluted 5% solution of dextrose in bags of polyvinyl chloride (PVC) or in glass bottles. Dilution of the solution should be carried out in a ratio of 1: 5 (2 mg propofol / ml for 1% Propovan) and in accordance with the rules of aseptic immediately before use. The mixture is stable for 6 hours. Diluted solution Propovan can be administered using a variety of adjustable infusion systems, but the use of only similar devices does not completely avoid the risk of accidental, uncontrolled introduction of large volumes of diluted Propovan.Burettes, drip counters or dosing pumps should always be part of the infusion line. When calculating the maximum volume of diluted propofol in a burette, one should keep in mind the risk of uncontrolled administration.
Propovan can be introduced through a tee with a valve near the injection site in combination with a 5% solution of dextrose for intravenous administration, 0.9% solution of sodium chloride for intravenous administration or 4% solution of dextrose with 0.18% sodium chloride solution for intravenous administration.
To reduce pain during the initial injection, the dose of Propovanum directly before administration can be mixed with lidocaine for injection in a plastic syringe in the following proportion: 20 parts Propovanone and one part 0.5% or 1% lidocaine solution.
Duration of administration: Drink should not exceed 12 hours. At the end of the infusion of the drug or after 12 hours, it is necessary to replace the equipment for the administration of Propovan.
The remaining portions of the drug must be destroyed.
To reduce the likelihood of side effects associated with the activation of the vagus nerve, it is advisable to introduce intravenously M-cholinolytics before the initial anesthesia.
Introductory anesthesia
Propovan can be used for an introductory general anesthesia through a slow bolus or infusion. Regardless of whether premedication was or was not performed, the dose of Propovan is recommended to be titrated (bolus or infusion of approximately 40 mg every 10 seconds for an adult patient in a satisfactory condition), depending on the patient's reaction prior to the appearance of clinical signs of anesthesia. For most adult patients under 55 years of age, the average dose of Propovan is 1.5-2.5 mg / kg. The total required dose can be reduced using lower injection rates (20-50 mg / min). For patients older than 55 years, usually a lower dose is required. Patients 3 and 4 classes ASA (American Society of Anaesthesiologists, Grade 3 - patients with severe systemic disorders, Grade 4 - patients with severe life-threatening systemic disorders), administration should be performed at a lower rate (approximately 20 mg every 10 seconds).
Maintaining general anesthesia
Anesthesia can be maintained by continuous infusion. Propovan or by repeated injections of boluses required to maintain the necessary depth of general anesthesia.
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 general anesthesia.
Bolus injection: depending on the clinical picture, doses of 25 to 50 mg are used.
Propovan requires additional use of analgesics. Propovan is well combined with spinal and epidural anesthesia; with drugs commonly used for premedication; with muscle relaxants, means for inhalation anesthesia and analgesics. Lower doses of Propovan can be used in cases where general anesthesia is performed as a supplement to the methods of regional anesthesia used.
Ensuring a sedative effect during intensive care
When using the drug Propovan in order to provide a sedative effect in adult patients on ventilating and receiving intensive therapy, it is recommended to use it through continuous infusion. The rate of infusion should be adjusted according to the required depth of sedation.The rate of administration in the range 0.3-4.0 mg / kg / h should ensure a satisfactory sedative effect.
Ensuring sedation in patients who are conscious, during surgical and diagnostic procedures
To ensure a sedative effect in patients who are conscious during surgical and diagnostic procedures, the rate of administration and dose should be selected individually depending on the clinical response of the patient.
For the majority of patients, 0.5-1.0 mg / kg 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, at a rate of 1.5-4.5 mg / kg / h. As an additive to the infusion, bolus administration of 10-20 mg of Propovan can be used to rapidly increase the depth of sedation if required. For patients 3 and 4 classes ASA it may be necessary to reduce the dose and rate of administration.
For elderly patients
Propovan should be titrated depending on the reaction of the patient. Patients over 55 years of age usually require lower doses forintroductory anesthesia and to provide a sedative effect in the conduct of surgical and diagnostic procedures in the state of consciousness.