Propofol

Your progress

Saved on this device.

Target exams

Red flags

• Propofol causes dose-dependent hypotension (taught: vasodilation with myocardial depression; exact fall varies with dose/age/volume — titrate to effect per local formulary; Kazokas adjunct-exact only owns -3 mg/kg propofol sparing with remimazolam, not the hypotension number) — it is the wrong agent for the shocked, hypovolaemic or severely cardiac-compromised patient; choose ketamine or etomidate instead.
• Propofol infusion syndrome (PRIS) is a rare but often-fatal complication of prolonged high-dose sedation (El-Medany-exact warning: >4 mg/kg/h or >48 h, 21M TBI sine-wave case with acidosis/rhabdomyolysis/hypertriglyceridaemia and Brugada-like pattern, refractory once sinusoidal — early cessation only; especially children): metabolic acidosis, rhabdomyolysis, cardiac failure, hyperkalaemia and lipaemia from mitochondrial fatty-acid oxidation blockade — stop the propofol the moment it is suspected.
• The lipid emulsion vehicle supports bacterial growth (taught formulation point; no pack ref owns the 6-hour number — follow local asepsis/discard protocol) — strict asepsis is mandatory.
• Propofol causes dose-dependent respiratory depression and apnoea is common after an induction dose (taught; Pathak simulation-exact owns only a macaque-confirmed residual-activity biomarker, not apnoea rates) — equipment for airway control and ventilation must be immediately available, and it must not be used by an unmonitored operator.
• Pain on injection is commonest in a small dorsal hand vein (taught; no pack ref owns vein/lidocaine numbers — follow local formulary) — use a large antecubital vein with lidocaine pretreatment per local protocol.
• Propofol crosses the placenta (taught) and a high dose immediately before caesarean delivery causes neonatal depression — restrict the dose before cord clamping per local obstetric protocol.