Propofol
RSI induction, Procedural sedation, Post-intubation sedation
Indications
- RSI induction
- Procedural sedation
- Post-intubation sedation
Adult dosing
- rsi: dose: 1.5; maxDose: 200; maxDoseAbsolute: true; unit: mg/kg; route: IV; weightBased: true; sedation: dose: 0.5; maxDose: 100; maxDoseAbsolute: true; unit: mg/kg; route: IV; weightBased: true; infusion: dose: 5; maxDose: 50; unit: mcg/kg/min; route: IV; weightBased: true; titrationTarget: Titrate to sedation goal (RASS target)
Pediatric dosing
- rsi: dose: 2.5; maxDose: 200; maxDoseAbsolute: true; unit: mg/kg; route: IV; weightBased: true; pedNote: Use in children >3 years only
Contraindications
- Egg or soy allergy (relative)
- Hemodynamic instability — causes significant hypotension
- Propofol infusion syndrome risk with prolonged high-dose infusions
Clinical pearls
- Causes dose-dependent hypotension — use cautiously or avoid in hypotensive patients; ketamine or etomidate preferred in hemodynamically unstable patients
- Excellent choice for post-intubation sedation infusion in normotensive patients
- Burns on injection — can pretreat with lidocaine 40mg IV
- Propofol infusion syndrome: rare but fatal — avoid >4mg/kg/hr for >48 hours
Source and review
- Tintinalli's Emergency Medicine, 9th ed.; Roberts & Hedges, 7th ed.. Last reviewed: 2024-11-01