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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 *
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