Propofol

Adults: Dosage for Adults Induction of general anaesthesia: The dose of Propofol should be adjusted for each patient based on how they respond. The usual starting dose in adults is 40 mg (4 ml) given by slow intravenous bolus injection at intervals of 10 seconds, continued until clinical signs show that anaesthesia has begun. The usual induction dose in a healthy patient under 55 years of age is 2.2 to 2.5 mg/kg. A dose of 1.0 to 1.5 mg/kg is often enough for an older patient. Lower doses, most often 20 mg (2 ml) at intervals of 10 seconds, are recommended for patients of ASA grades 3 and 4. Maintenance of general anaesthesia: Anaesthesia can be maintained by giving Propofol either as a continuous infusion or as repeated bolus injections to keep the patient sufficiently anaesthetised. For continuous infusion, the rate needed varies considerably from patient to patient. At the start of anaesthesia, roughly during the first 10 to 20 minutes, some patients may need a slightly higher infusion rate of 8 to 10 mg/kg/h. However, sufficient anaesthesia is normally achieved with an infusion of 4 to 6 mg/kg/h, and sometimes up to 12 mg/kg/h. For repeated bolus injections, doses of 25 to 50 mg (2.5 to 5.0 ml) can be given depending on the patient's response. Sedation during intensive care: A bolus injection of 1.0 to 2.0 mg/kg should be given first, followed by a continuous infusion adjusted to the degree of sedation required. An infusion rate of 0.3 to 4 mg/kg/h is usually enough. Sedation for surgical and diagnostic procedures: Doses should be adjusted for each patient. Sufficient sedation for surgical and diagnostic procedures can usually be achieved by giving an initial dose of 0.5 to 1 mg/kg over 1 to 5 minutes, then maintaining sedation with a continuous infusion at a rate of 1 to 4.5 mg/kg/h. A bolus dose of 10 to 20 mg can be given in addition if deeper sedation is suddenly needed. Lower doses of Propofol are often enough for patients of ASA grades 3 and 4, and for older patients. Children: Propofol is not recommended for children under 3 years of age, as its safety has not been demonstrated in this age group. Induction of general anaesthesia: The dose of Propofol in children should be adjusted for weight and age. The average induction dose in children over 8 years is 2.5 mg/kg, given by slow intravenous injection until clinical signs show that anaesthesia has begun. Younger children may need slightly higher doses of Propofol per kilogram of body weight. Lower doses are recommended for children of ASA grades 3 and 4. Maintenance of general anaesthesia: Anaesthesia can be maintained by giving Propofol either as a continuous infusion or as repeated bolus injections. The dose should be adjusted for each child, but an infusion rate of 9 to 15 mg/kg/h is usually enough to achieve satisfactory anaesthesia. Sedation during intensive care and for surgical or diagnostic procedures: Propofol is not recommended for sedation in children, as its effectiveness and safety have not been demonstrated for this use. Although no causal link has been established, serious adverse events, including deaths, have been reported in cases where Propofol was used against these recommendations. Adverse events have most commonly been seen in children with respiratory tract infections who were given doses higher than those recommended for adults.