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What are the characteristics of propofol infusion syndrome?
- metabolic acidosis
- renal insufficiency
- death secondary to cardiovascular collapse
- increased risk in children with long term sedation.
How does propofol work?
Propofol works by increasing GABA-mediated inhibitory tone in the CNS. Propofol decreases the rate of dissociation of GABA from its receptor, thereby increasing the duration of the GABA activated opening of the chloride channel with resulting hyperpolarization of cell membranes.
What is GABA?
gamma -aminobutyric acid
- GABA reduces the activity of the neurons to which it binds.
- It is classified as an inhibitory neurotransmitter.
- Estimated that 40% of the synapses in the human brain work with GABA and therefore have GABA receptors.
- Propofol supports the growth of bacteria. Sterile technique must be observed. Sepsis an death have been linked to contaminated propofol preparations.
- Must be administered within 6 hours of opening vial.
What are the CV effects of propofol?
- decreased ABP
- decreased SVR
- decreased preload
- decreased contractility
- impairs baroreceptor reflex to hypotension
What are the effects of propofol on the respiratory system?
- profound depressant causing apnea following induction dose
- subanesthetic doses used in conscious sedation, inhibits hypoxic ventilatory drive and depresses the normal response to hypercarbia
- depresses upper airway reflexes
- releases histamine, but induction with propofol is accompanied by a lower incidence of wheezing in asthmatic and nonasthmatic patients compared with barbiturates and etomidate