Propofol, Propofol-28

Question 1

What is the difference between propofol and propofol-28?

Answer 1

Propofol-28 contains preservative benzyl alcohol

• 28 day shelf life
• Hence regular propofol should be discarded with 6-8 hours
• Refrigeration will not stop bacterial growth

Question 2

Why is propofol a good choice for patients with hepatic disease?

Answer 2

*metabolised not only by the liver but by other organs too like kidneys and lungs

Question 3

Why is propofol a good choice for head trauma patients?

Answer 3

They cause a decrease in cerebral blood flow, intracranial pressure and cerebral metabolic oxygen requirements

Question 4

Precautions with propofol

Answer 4

• significant respiratory depression
• apnea and hypotension (from decrease myocardial contractility and impairs baroreceptor reflex response) is common if administered too fast at induction
• if given without premedication = excitatory response can occur if given too slowly
• muscle twitching
• rigidity, paddling, possible opisthotonus (bridging or arching position)

Question 5

Propofol in cats

Answer 5

• not FDA approved for use in cats
• decrease ability to metabolise phenol compounds
• oxidative injury to the red blood cells causing Heinz body formation, diarrhoea, anorexia, malaise and prolonged recovery