Respiratory depression should be treated by artificial ventilation and oxygen. 10. Concurrent medication: No significant adverse interactions with commonly used drugs have been observed. Consult a physician if irritation persists. NLM PMID: 2788953 [PubMed - indexed for MEDLINE] Publication Types: Letter; MeSH Terms. Propofol undergoes oxidative degradation in the presence of oxygen and is therefore packaged under nitrogen to eliminate this degradation path. aesthetised with propofol but there are reports about other drugs as well, e.g. 8. HUMAN USER SAFETY: Not for human use. Strict aseptic techniques must always be maintained during handling since the vehicle is capable of supporting the rapid growth of microorganisms. PropoFlo™ is supplied in cartons of five-20 mL (200 mg per vial) vials containing 10 mg propofol per mL. In the clinical study, transient ventricular arrhythmias associated with propofol were observed in 2 of 145 animals induced and maintained on propofol. Am J Vet Res 59 157-161, 1998 4. Propofol: a review of its pharmacodynamlc and pharmacokmetm properties and use as an intravenous anaesthetic. All cases of apnea resumed normal breathing spontaneously, or responded satisfactorily to oxygen supplementation and/or controlled ventilation. In cases of respiratory depression, stop drug administration, establish a patent airway, and initiate assisted or controlled ventilation with pure oxygen. Intravenous propofol administration induced a variable period of apnea in 34 of 40 dogs. Smith, J.A., J.S. Shake the vial thoroughly before opening. 2016 Nov;9(11):1178-1183. doi: 10.14202/vetworld.2016.1178-1183. In case of contact, eyes and skin should be liberally flushed with water for 15 minutes. Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian. Nineteen dogs were used in this clinical study. Schedule your appointment now for safe in-person care. Venous CO2 tension increased and pH decreased immediately after propofol administration, regardless of preanesthetic regimen. Common side effects of propofol include an irregular heart rate, low blood pressure, a burning sensation at the site of injection and the cessation of breathing.  |  1999 Feb;14(1):38-43. doi: 10.1016/S1096-2867(99)80025-5. Enouri SS, Kerr CL, McDonell WN, Dyson DH. The duration of anesthesia following the recommended induction doses averages 6.7 minutes in premedicated and unpremedicated animals. No pharmacological incompatibility has been observed. The administration of propofol to patients with renal failure and/or hepatic failure has not been evaluated. Handbook of Veterinary Medicine, Second Edition. Clearly propofol does have … Epub 2016 Sep 11. Hemodynamic effects of target-controlled infusion of propofol alone or in combination with a constant-rate infusion of remifentanil in dogs. You may report side effects to FDA at 1-800-FDA-1088. Tell your caregiver right away if you have: Physiological effects: Mild hypotension may occur during propofol anesthesia. Whether this "seizure activity" is primarily, secondarily, or not at all a cerebral cortical event is still to be elucidated. The following table is provided for guidance: Repeated maintenance doses of propofol do not result in increased recovery times or dosing intervals, indicating that the anesthetic effects of propofol are not cumulative. The purpose of the present study was to evaluate the safety of use the propofol-thiopental mixture in brachycephalic dogs and the recovery quality when it is used for perform an ancillary diagnostic test of spinal condition, myelography. 1989 Aug 19;125(8):213. Once propofol has been opened, vial contents should be drawn into sterile syringes; each syringe should be prepared for single patient use only. Tips for achieving a better anesthetic experience when using these drugs are also discussed. Elimination from the central compartment occurs rapidly, with an initial elimination phase of less than 10 minutes1. Comparison of methohexital and propofol as induction agents for evaluation of laryngeal function in healthy dogs. Epub 2016 Nov 2. In case of contact, eyes and skin should be liberally flushed with water for 15 minutes. Exercise caution to avoid accidental self-injection. Anesthesia effects: Careful monitoring of the patient is necessary when using propofol as a maintenance anesthetic due to the possibility of rapid arousal. Breeding animals: The use of propofol in pregnant and breeding dogs has not been evaluated. (propofol injectable emulsion) Intravenous Anesthetic Injection for Use in Dogs. Propofol side effects. One dog developed ventricular premature depolarizations after propofol administration. Abstract We compared the effect of propofol and saline control on intradermal test reactions in dogs with atopic dermatitis undergoing outpatient intradermal testing (IDT). Effects of two preanesthetic regimens for ophthalmic surgery on intraocular pressure and cardiovascular measurements in dogs. Do not freeze. Short Periods Of Not Breathing 3. Propofol is … 2017 Jan 10;78(12):1907-1910. doi: 10.1292/jvms.16-0324. JAVMA 204:1888-1890, 1994 6. Muir IF. 6. Propofol contains no antimicrobial preservatives. Mosby-Year Book, Inc. (1995). Rapid single or repeat bolus administration may cause undesirable cardiorespiratory depression including hypotension, apnea and oxygen desaturation. JAVMA. Propofol injection is an intravenous sedative hypnotic agent for use in the induction and maintenance of anesthesia. J Vet Med Sci. Branson KR, Gross ME. Avoid inhalation and direct contact of this product with skin, eyes, and clothes. The SAP significantly (P < 0.05) decreased after propofol administration in dogs treated with acepromazine (SAP, 178 mm of Hg before vs 128 mm of Hg after propofol) and with acepromazine/butorphanol (SAP, 184 mm of Hg before vs 98 mm of Hg after propofol). It's given by … Langley MS, Heel RC. identified 13 patients with proven sensitivity to propofol [ 4 ]. Do not use if contamination is suspected. The dose of propofol should always be titrated against the response of the patient. The common side effects of propofol include pain on injection, hypotension, bradycardia, decreased cardiac output, hyperlipemia, and hypertriglyceridemia. This site needs JavaScript to work properly. 2018 Sep 12;14(1):282. doi: 10.1186/s12917-018-1608-8. Unused product should be discarded within 6 hours. Cardiopulmonary and anesthetic effects of propofol in wild turkeys. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Unused product should be discarded within 6 hours. These groups include either seizurelike (intermittent contractions with muscles alternatively contracting and relaxing) or dystonic (abnormal hypertonicity in the limbs) reactions. Administer by intravenous injection only. Vet Rec. Propofol should be managed to prevent the risk of diversion, through such measures as restriction of access and the use of drug accountability procedures appropriate to the clinical setting. In the clinical study, a total of 27 sighthounds were induced with propofol, 6 of which were maintained on propofol. enflurane and etomidate (2, 3). Anesthesiology 75:1035-1040 (1991). 4. Propofol crosses the placenta and, as with other general anesthetic agents, the administration of propofol may be associated with neonatal depression. 2019 Jan;48(1):70-78. doi: 10.1111/vsu.13110. Propofol doses and rates for the above premedicants were based upon the following average dosages. If experienced, these tend to have a Severe expression 1. Neonates: Propofol has not been evaluated in dogs less than 10 weeks of age. How Propofol is Supplied; Propofol is available in 10mg/ml concentration in 20 ml, 50 ml and 100 ml bottles. When used for induction, propofol induces anesthetic-related adverse effects, some of which can be minimized by preanesthetic medication. Enhancement by propofol of epinephrine-induced arrhythmias in dogs. More rare reactions to dog anesthesia are side effects like seizures, visual impairments, clotting disorders (like von Willebrand’s disease in dogs ), … Cyanosis (in 2 dogs) and signs of pain on injection (in 3 dogs) were infrequently observed during induction. Detailed information on the pharmacokinetics and metabolism of propofol can be obtained from Zoetis Inc. 2. 4. For induction, propofol injection should be titrated against the response of the patient over 30-60 seconds or until clinical signs show the onset of anesthesia. Four preanesthetic regimens were used: anesthesia without preanesthetic drugs; or with preanesthetic administration of acepromazine (0.1 mg/kg of body weight, IM), diazepam (0.2 mg/kg, IV), or acepromazine (0.02 mg/kg) and butorphanol (0.4 mg/kg) IM.  |  Rapid injection of propofol (≤ 5 seconds) may be associated with an increased incidence of apnea2. A review of the Committee for the Safety of Medicine (CSM) data revealed three fatalities in association with fentanyl, and 17 fatalities in association with propofol. Clinical trials using propofol have shown that it may be necessary to use a higher initial concentration of the inhalant anesthetic halothane than is usually required following induction using barbiturate anesthetics, due to rapid recovery from propofol5. Muir, W.W., J.A.E. Kamibayashi, T., Y. Hayashi, K. Sumikawa, A. Yamatodani, K. Kawabata and I. Yoshiya. The use of these drugs as preanesthetics markedly reduces propofol requirements. Keep out of the reach of children. Hubbell, R.T. Skarda, and R.M. Iowa State University Press, Ames, IA (1995). Do not use if there is evidence of excessive creaming or aggregation, if large droplets are visible, or if there are other forms of phase separation indicating that the stability of the product has been compromised. Get emergency medical help if you have any signs of an allergic reaction to propofol: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Moneret-Vautrin and J.L. Propofol 2–6 Decrease dose by co-inducing with 0.2–0.4 mg/kg of midazolam or diazepam Causes dose-dependent cardiorespiratory depression Fast onset, short duration, so easy to titrate to effect. Am J Vet Res. This article will briefly discuss the uses, duration of action, side effects, adverse effects, contraindications, and more of the drugs acepromazine, ketamine, and propofol in veterinary anesthesia. 3. Sighthounds: Propofol induction and maintenance produced satisfactory anesthesia and recoveries in sighthounds. In addition to the active component, propofol, the formulation also contains soybean oil (100 mg/mL), glycerol (22.5 mg/mL), egg lecithin (12 mg/mL), and oleic acid (0.6 mg/mL) with sodium hydroxide to adjust the pH. Updated: 2021-01-29. Keep out of the reach of children. Propofol injection is contraindicated in dogs with a known hypersensitivity to propofol or its components, or when general anesthesia or sedation are contraindicated. Perivascular administration: Perivascular administration does not produce local tissue reaction. Rare cases of self-administration have been reported, including fatalities. Hypersensitivity reactions to propofol, including anaphylaxis, may occur in some individuals who are also allergic to muscle relaxants 4. Other serious side effects may include seizures, infections due to improper use, addiction, and propofol infusion syndrome with long-term use. Not for human use. The propofol emulsion is isotonic and has a pH of 6.0-9.0. The use of certain premedicant combinations (e.g., acepromazine/oxymorphone) may result in prolonged recovery. 7. 3. Laxenaire, M.C., E. Mata-Bermejo, D.A. Slight creaming, which should disappear after shaking, may be visible upon prolonged standing. Heart rate, systolic arterial blood pressure (SAP), respiration, quality of induction and recovery, and adverse effects were induction and recovery, and adverse effects were recorded. Signs And Symptoms At Injection Site Fliptop vial. Propofol has been used in association with atropine, glycopyrrolate, acepromazine, xylazine, oxymorphone, halothane and isoflurane. Epub 2018 Oct 27. Similar to propofol, alfaxalone is an induction agent that, because of its short half-life in dogs and cats, is very suitable for repeated bolus injections or a continuous rate infusion (CRI). Recovery from propofol is rapid; full standing recovery is generally observed within 20 minutes. Please enable it to take advantage of the complete set of features! Cardiac arrhythmias: In one study, propofol increased myocardial sensitivity to the development of epinephrine-induced ventricular arrhythmias in a manner similar to other anesthetics6. PROPOFOL-THIOPENTAL MIXTURE IN BRACHYCEPHALIC DOGS ... All dogs were anesthetized by bolus IV administration of 0,5 ml/kg body weight ... reaction to sound and presence of side effects. Xenobiotica 2000;30L:575-588. 1. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Select one or more newsletters to continue. Would you like email updates of new search results? 5. Thompson RA. Respiratory arrest (apnea) may be observed. These doses may be lower than the label directions for their use as a single medication3,4. Zoran DL, Riedesel DH, Dyer DC. Abnormally Low Blood Pressure 2. Vet Surg. Tamura EY, Barros PS, Cortopassi SR, Ambrósio AM, Fantoni DT. Propofol is very slightly soluble in water and is therefore formulated as a white, oil-in-water emulsion. Induction of anesthesia will usually be observed within 75-120 seconds after the beginning of propofol administration. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Premedicants: Premedicants may increase the anesthesia or sedative effect of propofol and result in more pronounced changes in systolic, diastolic and mean arterial blood pressures. propofol should be replaced every twelve hours (3). Schumacher J, Citino SB, Hernandez K, Hutt J, Dixon B. Clin Tech Small Anim Pract. Do not use if contamination is suspected. The average propofol induction dose rates for healthy dogs given propofol alone, or when propofol is preceded by a premedicant, are indicated in the table below. Geriatric dogs may require less propofol for induction of anesthesia (see Dosage and Administration). Rare cases of self-administration have been reported, including fatalities. In the clinical study, a total of 27 sighthounds were induced with propofol, 6 of which were maintained on propofol. 11. Avoid inhalation and direct contact of this product with skin, eyes, and clothes. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. The primary side effect of propofol is respiratory depression as evidenced by tachypnea and apnea. Failure to follow aseptic handling procedures may result in microbial contamination causing fever, infection/sepsis, and/or other life-threatening illness. The dose and rate should be based upon patient response. 1989 Aug 19;125(8):213. Reaction to propofol. 1989 Jul 29;125(5):116. Propofol is regularly used for the induction and maintenance of anaesthesia in dogs and cats. Most adult patients under 55 years of age and classified as ASA-PS I or II require 2 to 2.5 mg/kg of propofol injectable emulsion for induction when unpremedicated or when premedicated with oral benzodiazepines or intramuscular opioids. The heart rate response to propofol administration in dogs remains less well defined. Anesthesia can be maintained by administering propofol in intermittent IV injections. This admixture was made by aseptically adding 200 mg of ketamine (Narketan 10, Vetoquinol, UK) to a 200 mg vial of propofol … COVID-19 is an emerging, rapidly evolving situation. Gueant. Intravenous propofol administration induced a variable period of apnea in 34 of 40 dogs. After she lies down, she starts chatting with the doctors. Hypersensitivity reactions to propofol, including anaphylaxis, may occur in some individuals who are also allergic to muscle relaxants4. Comment on Vet Rec. Hay Kraus BL, Greenblatt DJ, Venkatakrishnan K, et al. Repeat dosing is safe in both cats and dogs Alfaxalone 1–3 (D) 2–5 (C) Fast onset, short duration, easy to titrate to effect. Apnea may occur following maintenance doses of propofol. After different doses of propofol administered intravenous (IV) in dogs, either a significant increase of heart rate (HR) [ 1, 2] or no significant chronotropic effects [ 3, 4, 5, 7] have been reported. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Propofol injection is an intravenous sedative hypnotic agent for use in the induction and maintenance of anesthesia. Shake well before use. Our Diprivan (propofol) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication. The male:female ratio is 1:2 and the median age is 27 years. Cattai A, Rabozzi R, Ferasin H, Isola M, Franci P. BMC Vet Res. The effects of propofol on anesthetic induction were evaluated in 40 dogs anesthetized with isoflurane. Detailed information on the preanesthetic doses used with propofol in clinical studies is available in the Freedom of Information (FOI) Summary or can be obtained from Zoetis Inc. 5. It is now clear that "seizure activity", excitatory phenomena, and/or a disorder of muscle tone are potential complications of the use of propofol.  |  Overdose is likely to cause cardiorespiratory depression (such as hypotension, bradycardia and/or apnea). INCIDENCE Because the definition of PRIS has not been standard-ized, the exact incidence of propofol infusion syndrome is unclear. Strict aseptic techniques must always be maintained during handling since the vehicle is capable of supporting the rapid growth of microorganisms. Propofol is a strong anesthetic that's used for surgery, some medical exams, and for sedation for people on ventilators -- never as a sleep aid. Life-threatening anaphylactoid reactions to propofol (Diprivan®). Slow Heartbeat If experienced, these tend to have a Less Severe expression 1. Doses administered during the transition to inhalant anesthesia may result in apnea. Propofol contains no antimicrobial preservatives. Plumb, D.C. ed. However, it remains the responsibility of the readers to familiarize themselves with the product information contained on the US product label or package insert. USA.gov. 425), of an acute choreoathetoid reaction to propofol, is one of a series of similar reports in the medical literature (dating back to 1987)1-3 and was of considerable interest to us, since we have encountered similar phenomena in dogs. ... Intravenous injection of propofol in the dog is followed by extensive metabolism of propofol in the liver to inactive conjugates which are excreted in the urine. Don't delay your care at Mayo Clinic. Propofol is chemically described as 2, 6-diisopropylphenol and has a molecular weight of 178.27. Propofol is a white stable emulsion; do not use if there is evidence of separation of the phases. In the presence of premedication, the dose of propofol may be reduced with increasing age of the animal. Clipboard, Search History, and several other advanced features are temporarily unavailable. Life‐threatening reactions to propofol appear to be commoner than similar reactions to fentanyl. Data sources include IBM Watson Micromedex (updated 2 Feb 2021), Cerner Multum™ (updated 3 Feb 2021), ASHP (updated 29 Jan 2021) and others. As with other sedative hypnotic agents, the amount of opioid and/or α-2 agonist premedication will influence the response of the patient to an induction dose of propofol. 9. For induction of general anesthesia where maintenance is provided by inhalant anesthetics. Brown MB, Dugat DR, Lyon SD, Nafe LA, Payton ME, Peakheart SK, Salazar RS. For additional information about adverse drug experience reporting for animal drugs, contact FDA at 1-888-FDA-VETS or online at www.fda.gov/reportanimalae. In 1993, Laxenaire et al . Sighthounds: Propofol induction and maintenance produced satisfactory anesthesia and recoveries in sighthounds. In addition, the greater number of individual dogs experiencing more positive reactions ≥ 1+ during propofol … Propofol is a rapidly acting, nonbarbiturate drug that induces anesthesia of ultrashort duration with IV administration. Recovery may be delayed in Sighthounds. Anaphylaxis is defined as “a potentially fatal hypersensitive reaction to the invasion of an allergen or other substance that causes systemic allergic symptoms in multiple organs” and anaphylactic shock as “hypotension or impaired consciousness associated with anaphylaxis”. This table is for guidance only. Due to the rapid metabolism of propofol, additional low doses of propofol, similar to those used for maintenance with propofol, may be required to complete the transition to inhalant maintenance anesthesia. Excitatory reactions to propofol seem to generally occur in two groups based on descriptions of the abnormal movements.