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Clinical Techniques in Small Animal... Feb 1999Propofol can be used for sedation, induction of anesthesia, and maintenance of anesthesia in small animal patients. In all these situations recovery from its effects is... (Review)
Review
Propofol can be used for sedation, induction of anesthesia, and maintenance of anesthesia in small animal patients. In all these situations recovery from its effects is typically rapid and smooth. The drug should be administered slowly, intravenously, to minimize the negative cardiac and respiratory effects seen after rapid bolus administration. The currently available formulations do not contain preservatives, and sterile technique should be strictly followed during its use. Propofol can be used for induction of anesthesia in patients with preexisting disease with minimal delays in recovery. It does not cause excitement at low doses so is also useful for sedation of patients undergoing nonpainful procedures such as radiological examination. This review focuses on the diverse clinical applications for propofol in a small animal practice including indications, recommendations, and contraindications as well as a discussion of the controversies that surround its use.
Topics: Anesthetics, Intravenous; Animal Diseases; Animals; Cats; Dogs; Propofol; Veterinary Medicine
PubMed: 10193040
DOI: 10.1016/S1096-2867(99)80021-8 -
Drugs Oct 1995Propofol is a phenolic derivative that is structurally unrelated to other sedative hypnotic agents. It has been used extensively as an anaesthetic agent, particularly in... (Comparative Study)
Comparative Study Review
Propofol is a phenolic derivative that is structurally unrelated to other sedative hypnotic agents. It has been used extensively as an anaesthetic agent, particularly in procedures of short duration. More recently it has been investigated as a sedative in the intensive care unit (ICU) where it produces sedation and hypnosis in a dose-dependent manner. Propofol also provides control of stress responses and has anticonvulsant and amnesic properties. Importantly, its pharmacokinetic properties are characterised by a rapid onset and short duration of action. Noncomparative and comparative trials have evaluated the use of propofol for the sedation of mechanically ventilated patients in the ICU (postsurgical, general medical, trauma). Overall, propofol provides satisfactory sedation and is associated with good haemodynamic stability. It produces results similar to or better than those seen with midazolam or other comparator agents when the quality of sedation and/or the amount of time that patients were at adequate levels of sedation are measured. Patients sedated with propofol also tend to have a faster recovery (time to spontaneous ventilation or extubation) than patients sedated with midazolam. Although most studies did not measure time to discharge from the ICU, propofol tended to be superior to midazolam in this respect. In a few small trials in patients with head trauma or following neurosurgery, propofol was associated with adequate sedation and control of cerebral haemodynamics. The rapid recovery of patients after stopping propofol makes it an attractive option in the ICU, particularly for patients requiring only short term sedation. In short term sedation, propofol, despite its generally higher acquisition costs, has the potential to reduce overall medical costs if patients are able to be extubated and discharged from the ICU sooner. Because of the potential for hyperlipidaemia and the development of tolerance to its sedative effects, and because of the reduced need for rapid reversal of drug effects in long term sedation, the usefulness of propofol in long term situations is less well established. While experience with propofol for the sedation of patients in the ICU is extensive, there are still areas requiring further investigation. These include studies in children, trials examining cerebral and haemodynamic outcomes following long term administration and in patients with head trauma and, importantly, pharmacoeconomic investigations to determine those situations where propofol is cost effective. In the meantime, propofol is a well established treatment native to benzodiazepines and/or other hypnotics or analgesics when sedation of patients in the ICU is required. In particular, propofol possesses unique advantages over these agents in patients requiring only short term sedation.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Clinical Trials as Topic; Humans; Hypnotics and Sedatives; Intensive Care Units; Propofol
PubMed: 8536552
DOI: 10.2165/00003495-199550040-00006 -
Journal of Palliative Medicine Jan 2010We undertook a systematic review of published evidence of the effectiveness of propofol for terminal sedation. INCLUSIONS: Prospective or retrospective trials... (Review)
Review
INTRODUCTION
We undertook a systematic review of published evidence of the effectiveness of propofol for terminal sedation. INCLUSIONS: Prospective or retrospective trials (controlled or uncontrolled) or case series of propofol for sedation in advanced incurable disease in either generalist setting or specialist palliative care units.
EXCLUSIONS
Use in anesthetic or intensivist settings (e.g., intensive care units); pediatric use. Identification of relevant studies: Using the search terms: [Hospice Care/OR Terminal Care/OR Palliative Care/OR palliative.mp] AND [Propofol/]. Studies were identified using a detailed search strategy from a number of electronic databases: Embase (1988-2005); MEDLINE (1966-2005) Cinahl (1982-2005), Cancerlit (1962-2005) The Cochrane Database of Systematic Reviews 2005 Issue 4. Hand searches of a number of palliative care journals were also undertaken (Palliative Medicine, Journal of Pain and Symptom Management, Progress in Palliative Care, Journal of Palliative Care, Journal of Palliative Medicine). No restriction was placed on the language of the original article.
RESULTS
Four articles--all case series or case reports--reporting generally favorable reports of the use of propofol as sedation for intractable symptoms in the last days of life especially when one or more other drugs have failed. Since these four articles are essentially hypothesis-generating, the article also discusses the possibility of the design of a clinical trial to compare propofol with other drugs used in this situation.
Topics: Humans; Hypnotics and Sedatives; Palliative Care; Propofol; Terminal Care
PubMed: 19827968
DOI: 10.1089/jpm.2009.0126 -
Neuroscience Bulletin Dec 2023
Topics: Propofol; Depression
PubMed: 37815691
DOI: 10.1007/s12264-023-01133-7 -
The Journal of General Physiology Sep 2018Tandem studies investigate how propofol affects voltage-gated sodium channels.
Tandem studies investigate how propofol affects voltage-gated sodium channels.
Topics: Anesthetics, Intravenous; Propofol
PubMed: 30115662
DOI: 10.1085/jgp.201812197 -
Clinical Toxicology (Philadelphia, Pa.) Mar 2010Propofol is a sedative-hypnotic prescription medication that is widely used in anesthesia, long-term sedation, and conscious sedation. It is short acting, effective,... (Review)
Review
CONTEXT
Propofol is a sedative-hypnotic prescription medication that is widely used in anesthesia, long-term sedation, and conscious sedation. It is short acting, effective, and, when used appropriately, safe. It is not a controlled substance by the U.S. Drug Enforcement Administration, suggesting that it has little potential for abuse. The objective of this review was to evaluate the evidence for the abuse potential of propofol.
METHODS
A systematic review of the medical literature was performed using the search terms: propofol, Diprivan, abuse, addiction, tolerance, misuse, and withdrawal. Six online literature citation databases and relevant bibliographies were searched for articles.
RESULTS
Seventy-two articles were identified for review and 45 were relevant to the topic. These articles described propofol's biochemical and pharmacokinetic mechanisms of action that lend themselves to its abuse, propofol's physical and psychological effects that make it alluring as a recreational drug, the current evidence supporting the possibility of tolerance to and withdrawal from propofol, the risk involved in recreational propofol use, and the evidence supporting current abuse of this medication. We found evidence to support propofol's abuse potential from a pharmacological and experiential standpoint with multiple reports describing tolerance, dependence, withdrawal phenomena, abuse, and death from recreational use.
CONCLUSIONS
Propofol has alluring and addictive properties that lend itself to potential recreational abuse and dependence. We recommend that the U.S. Drug Enforcement Administration and other international agencies should consider regulating propofol as a controlled substance.
Topics: Anesthetics, Intravenous; Animals; Drug Tolerance; Drug and Narcotic Control; Humans; Propofol; Substance Abuse, Intravenous; Substance Withdrawal Syndrome; United States
PubMed: 20397799
DOI: 10.3109/15563651003757954 -
Molecules (Basel, Switzerland) Nov 2021Herein, we report a continuous flow process for the synthesis of 2,6-diisopropylphenol-also known as Propofol-a short-acting intravenous anesthesia, widely used in...
Herein, we report a continuous flow process for the synthesis of 2,6-diisopropylphenol-also known as Propofol-a short-acting intravenous anesthesia, widely used in intensive care medicine to provide sedation and hypnosis. The synthesis is based on a two-step procedure: a double Friedel-Crafts alkylation followed by a decarboxylation step, both under continuous flow.
Topics: Anesthesia, Intravenous; Humans; Hypnosis, Anesthetic; Propofol
PubMed: 34885756
DOI: 10.3390/molecules26237183 -
Journal of Neurosurgery Jun 2002
Topics: Adolescent; Heart Failure; Humans; Infusions, Intravenous; Male; Propofol; Renal Insufficiency; Rhabdomyolysis; Syndrome
PubMed: 12066924
DOI: No ID Found -
Biomedicine & Pharmacotherapy =... May 2024Propofol, a commonly used intravenous anesthetic, has demonstrated potential in protecting against myocardial ischemia/reperfusion injury (MIRI) based on preclinical... (Meta-Analysis)
Meta-Analysis Review
Propofol, a commonly used intravenous anesthetic, has demonstrated potential in protecting against myocardial ischemia/reperfusion injury (MIRI) based on preclinical animal studies. However, the clinical benefits of propofol in this context are subject to debate. We conducted a systematic search across eight databases to identify all relevant animal studies investigating the preventive effects of propofol on MIRI until October 30, 2023. We assessed the methodological quality of the included studies using SYRCLE's bias risk tool. Statistical analysis was performed using STATA 15.1. The primary outcome measures analyzed in this study were myocardial infarct size (IS) and myocardial injury biomarkers. This study presents a comprehensive analysis of 48 relevant animal studies investigating propofol's preventive effects on MIRI. Propofol administration demonstrated a reduction in myocardial IS and decreased levels of myocardial injury biomarkers (CK-MB, LDH, cTnI). Moreover, propofol improved myocardial function parameters (+dp/dtmax, -dP/dtmax, LVEF, LVFS), exhibited favorable effects on inflammatory markers (IL-6, TNF-α) and oxidative stress markers (SOD, MDA), and reduced myocardial cell apoptotic index (AI). These findings suggest propofol exerts cardioprotective effects by reducing myocardial injury, decreasing infarct size, and improving heart function. However, the absence of animal models that accurately represent comorbidities such as aging and hypertension, as well as inconsistent administration methods that align with clinical practice, may hinder its clinical translation. Further robust investigations are required to validate these findings, elucidate the underlying mechanisms of propofol, and facilitate its potential translation into clinical practice.
Topics: Propofol; Animals; Myocardial Infarction; Myocardial Reperfusion Injury; Oxidative Stress; Biomarkers; Anesthetics, Intravenous; Humans; Apoptosis
PubMed: 38640712
DOI: 10.1016/j.biopha.2024.116629 -
Anasthesiologie, Intensivmedizin,... Jun 2013Propofol is a common hypnotic agent in anaesthesiology and intensive care medicine and for procedural sedation as well. Despite the intensive usage the full potential,... (Review)
Review
Propofol is a common hypnotic agent in anaesthesiology and intensive care medicine and for procedural sedation as well. Despite the intensive usage the full potential, pharmacokinetic and -dynamic abilities, interactions and side effects of the substance may not be realized by all providers. Additionally there is dispute and unwarranted myth about the substance. Propofol is a highly potent hypnotic with a wide range of (un)desired effects. This article is reviewing the diversity of the substance in clinical practice.
Topics: Anesthetics, Intravenous; Antiemetics; Capital Punishment; Conscious Sedation; Contraindications; Drug Contamination; Edetic Acid; Emulsions; Excipients; Germany; Hemodynamics; History, 20th Century; Humans; Immunologic Factors; Propofol
PubMed: 23828078
DOI: 10.1055/s-0033-1349000