Propofol - 7

Precautions

Side effects
  • Pain on injection
    • less than or equal to etomidate pain but greater than usually painless thiopental
    • minimize by mixing with lidocaine or pre-administering lidocaine (0.5-1 mg/kg)
  • Significantly increased risk of bradycardia compared with other anesthetics (Tramer et al, 1997)
      Overall NNH (number-needed-to-harm) = 11.3
      Pediatric strabismus surgery: NNH = 4.1
  • Myoclonus (thiopental < propofol < etomidate or methohexital)
  • Apnea (less with infusion; avoid boluses)
  • Hypotension (especially with narcotics; less with infusion)
  • Phlebitis (rare)
  • Reported to cause tissue necrosis on subcutaneous extravasation in small children *


Greg Gordon MD
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