Propofol is an intravenous anaesthetic agent used for induction and maintenance of general anaesthesia. IV administration of propfol is used to induce unconsciousness after which anaesthesia may be maintained using a combination of medications. 

Recovery from propofol-induced anaesthesia is generally rapid and associated with less frequent side effects (e.g. drowsiness, nausea, vomiting) than with thiopental, methohexital, and etomidate. Propofol may be used prior to diagnostic procedures requiring anaesthesia, in the management of refractory status epilepticus, and for induction and/or maintenance of anaesthesia prior to and during surgeries.

Anesthesia medicine may affect brain development in a child under 3, or an unborn baby whose mother receives this medicine during late pregnancy.

 Important information





Anesthesia medicine may affect brain development in a child under 3, or an unborn baby whose mother receives this medicine during late pregnancy. These effects may be more likely when the anesthesia is used for 3 hours or longer, or used for repeated procedures. Effects on brain development could cause learning or behavior problems later in life.

Negative brain effects from anesthesia have been seen in animal studies. However, studies in human children receiving single short uses of anesthesia have not shown a likely effect on behavior or learning. More research is needed.

In some cases, your doctor may decide to postpone a surgery or procedure based on these risks. Treatment may not be delayed in the case of life-threatening conditions, medical emergencies, or surgery needed to correct certain birth defects.
Ask your doctor for information about all medicines that will be used during your surgery or procedure. Also ask how long the procedure will last.

Propofol can pass into breast milk and may harm a nursing baby. However, as propofol acts and leaves the body quickly, most women can resume breastfeeding as soon as they are recovered from anesthesia and fully awake.

Pharmacodynamics 

Propofol is a sedative-hypnotic agent for use in the induction and maintenance of anesthesia or sedation. Intravenous injection of a therapeutic dose of propofol produces hypnosis rapidly with minimal excitation, usually within 40 seconds from the start of an injection (the time for one arm-brain circulation).

Anesthesia

Propofol is used for induction and maintenance (in some cases) of general anesthesia, having largely replaced sodium thiopental. It can also be administered as part of an anesthesia maintenance technique called total intravenous anesthesia using either manually-programmed infusion pumps or computer-controlled infusion pumps in a process called target controlled infusion or TCI. 

Propofol is also used to sedate individuals who are receiving mechanical ventilation but are not undergoing surgery, such as patients in the intensive care unit. In critically ill patients, propofol has been found to be superior to lorazepam both in effectiveness and overall cost.  Propofol is relatively inexpensive compared to medications of similar use due to shorter ICU stay length.  One of the reasons propofol is thought to be more effective (although it has a longer half life than lorazepam) is because studies have found that benzodiazepines like midazolam and lorazepam tend to accumulate in critically ill patients, prolonging sedation

Procedural sedation






Propofol is also used for procedural sedation. Its use in these settings results in a faster recovery compared to midazolam. It can also be combined with opioids or benzodiazepines. Because of its fast induction and recovery time, propofol is also widely used for sedation of infants and children undergoing MRI.  It is also often used in combination with ketamine with minimal side effects.

Executions

The Missouri Supreme Court decided to allow the use of propofol to execute prisoners condemned to death. However, the first execution by administration of a lethal dose of propofol was halted on 11 October 2013 by Governor Jay Nixon following threats from the European Union to limit the drug's export if it were used for that purpose. The United Kingdom had already banned the export of medicines or veterinary medicines containing propofol to the United States

Side effects

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.
Long-term use of propofol can lead to a syndrome called Propfol Infusion Syndrome, which may result in death.
·        a light-headed feeling (like you might pass out) even after feeling awake;
·        weak or shallow breathing; or
·        Severe pain or discomfort where the injection is given.
·        mild itching or rash;
·        fast or slow heart rate; or
·        Slight burning or stinging around the IV needle.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.