Propofol(Diprivan)andItsAdverseEffectinAnesthesia：丙泊酚（异丙酚）和它的不良影响在麻醉.pptVIP

Propofol (Diprivan) and It’s Adverse Effect in Anesthesia Liu, Chih-Min 2003-8-19 2,6-diisopropylphenol Propofol Indications: Anesthesia, general Pregnancy Category B FDA Approved 1989 Oct 2,6-diisopropylphenol molecular weight of 178.27. isotonic pH of 7-8.5 Mechanism of Action The actual mechanism of action is unknown, but it is postulated that propofol mediates activity of the GABA receptors. rapid sedation with minimal excitatory activity no analgesic properties Pharmacokinetics eliminated by hepatic conjugation to inactive metabolites, excreted by the kidney No dosage adjustments are needed for patients with renal or hepatic failure Geriatrics age-related decrease in volume of distribution higher peak plasma concentrations cardiorespiratory effects including hypotension, apnea, airway obstruction, and/or oxygen desaturation INDICATIONS AND USAGE: induction and/or maintenance of anesthesia in adult patients and pediatric patients greater than 3 years of age not recommended for obstetrics not recommended for use in nursing mothers Pediatric Use not recommended in: induction of anesthesia in patients younger than 3 years of age maintenance of anesthesia in patients younger than 2 months of age not indicated for use in pediatric patients for ICU sedation Cardiac Anesthesia well-studied in coronary artery disease, but valvular or congenital heart disease is limited decrease in blood pressure that is secondary to decreases in preload and afterload lower heart rates possibly due to reduction of the sympathetic activity and/or resetting of the baroreceptor reflexes anticholinergic agents should be administered when increases in vagal tone are anticipated Induction of General Anesthesia Healthy Adults Less Than 55 Years of Age: 40 mg every 10 seconds until induction onset (2-2.5 mg/kg). Elderly, Debilitated, or ASA III/IV Patients: 20 mg every 10 seconds until induction onset (1-1.5 mg/kg). Cardiac Anesthesia: 20 mg every 10 seconds un