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2001, Number 6

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Med Crit 2001; 15 (6)

Propofol: the other side of the coin

Carrillo ER, González SJA, Serralde ZA

Language: Spanish
References: 31
Page: 214-217
PDF size: 59.16 Kb.


ABSTRACT

Propofol is widely used in the management of critically ill patients. It has sedative-hypnotic action and a rapid onset and short duration of sedation once discontinued has been described; sedative infusion doses of this agent result in minimal hemodynamic alterations with no change in perfusion pressure. Propofol has been used to sedate neurosurgical patients to reduce elevated intracranial pressure and may also decrease cerebral blood flow and metabolism. Several case reports describing the efficay of propofol in refractory status epilepticus. In the other hand, has been recently reported, that use of propofol can be associated to serious side effects. Long-term or high dose infusion may result in hypertriglyceridemia. It is a potent respiratory depresant, causing a reduction in systemic vascular resistance. It has been observed excitatory phenomena, such as myoclonus and seizures, with the use of propofol. Prolonged use of this drug has been asssociated with lactic acidosis and lipemia. It has been reported serious adverse affects such as cardiac failure (in prolonged high doses infusion) arrhythmias, hypotension and cardiac arrest as wel as fatal postoperative infection and septic shock. The use of propofol is not currently recommended for pediatric patients in the ICU. Finally, the use of this new agent in the sedation of ICU adult patients remains to be determinated.


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