Alternative Techniques Flashcards
Propofol sedation dose
Potent IV sedation 10mg/ml and 20ml ampules
Propofol metabolite
2,6-isopropylphenol
Propofol half life
2-4 mins alpha
30-60 mins beta
Due to half life of propofol
Constant infusion is given
Propofol metabolised by liver and
Excreted by kidney
Propofol advantages
1-5 mins onset
5-20 min recovery
Minimal side effects
Propofol disadvantages
Continuous infusion required
Expensive equipment
No reversal
Painful infusion
Anaesthetist required
BZD combinations
1) Midazolam + propofol
2) Midazolam and opioid (narrow safety margins)
Propofol side effects
Respiratory depression
Hypotension
Sens for egg allergy
Avoid in children and very elderly
Fentanyl properties
? potent than morphine
Peak effect at
Resp depression at
More rapid action
100% more potent than morphine
Peak effect at 10 mins
Respiratory depression at high doses
Sevofluorane IHS
Licenced?
Titrated in?
MAC of?
Not licensed for dental tx
Titrated in oxygen/N2O
<2 - very potent and narrow margin of safety
Advantages of ketamine
Useful for painful procedures in children
Disadvantages of ketamine
Sickness
Nausea
Apnoea
Ketamine mechanism
No guidance
Sedative drug binds to opioid receptors and triggers sympathetic response
Increased heart rate, cardiac output and BP
Contraindications of ketamine
CVS
Pulmonary disease
Glaucoma/globe injury
Non fasted patients
