Sedation, analgesia and paralysis
Propofol (Diprivan) drip
Diprivan
Dosing
| Start | 5 mcg/kg/min (0.3 mg/kg/h) |
|---|---|
| Titrate | 5–10 mcg/kg/min every 5–10 minutes to the sedation goal |
| Maximum | 50 mcg/kg/min usual; over 5 mg/kg/h (83 mcg/kg/min) for over 48 hours raises PRIS risk (label; some sources use 4) |
| Common bags | 1,000 mg in 100 mL (10 mg/mL) |
| Dose units | mcg/kg/min, mg/kg/h |
Line and administration
- Lipid: change tubing every 12 hours; aseptic technique
- Its 1.1 kcal/mL counts toward nutrition
Watch for
- Hypotension
- Triglycerides
- PRIS: acidosis, rhabdomyolysis, high K, arrhythmia
Propofol: full drug monographIndications, mechanism, pharmacokinetics, cautions and every dose the app lists.
In the one-pagers
- Airway and RSIRSI drugs: Propofol: 2–2.5 mg/kg; 1–1.5 if frail: About 40 s: Hypotension, apnea
- Asthma and COPD ExacerbationsIntubating severe asthma: Rapid sequence: ketamine 1–2 mg/kg (bronchodilates, less hypotension) or propofol, with rocuronium 1–1.2 mg/kg or succinylcholine
- ABG Interpretation in 6 StepsCauses in depth: High-gap acidosis: MUDPILES is the classic list (methanol, uremia, DKA, propylene glycol, isoniazid and iron, lactate, ethylene glycol, salicylates). GOLDMARK (Mehta 2008) fits the ICU better: glycols, 5-oxoproline (regular acetaminophen in malnourished or septic patients), L-lactate, D-lactate (short bowel), methanol, aspirin, renal failure and ketoacidosis (diabetic, alcoholic,
- Neuro: ICP and StrokeSeizures, cEEG, prognosis after arrest and brain death: In ESETT (2019) levetiracetam 60 mg/kg (max 4,500 mg), fosphenytoin 20 mg PE/kg (max 1,500) and valproate 40 mg/kg (max 3,000) each stopped status in about half. Give fosphenytoin no faster than 150 mg PE/min on a cardiac monitor. Refractory status needs midazolam, propofol, ketamine or pentobarbital infusions titrated on cEEG for 24–48 h, th
- Obstetric EmergenciesDrugs in pregnancy in the ICU: Propofol, opioids, dexmedetomidine: Yes: Neonatal depression near delivery
- Pediatric Assessment and EmergenciesDKA, cerebral edema and status epilepticus: Over 40 min: Anesthetic infusion: Midazolam, pentobarbital or propofol, with EEG
Practice Airway and RSI questions free196 exam-style questions with rationales on the topic where propofol comes up most. No account or download needed.
Other sedation, analgesia and paralysis
- Dexmedetomidine
- Midazolam
- Fentanyl
- Cisatracurium
- Ketamine
- Hydromorphone
- Rocuronium
- Vecuronium
- Pentobarbital
- Remifentanil
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For education and exam preparation only. Follow your institution’s protocols. Study aid: check every dose against your local protocols and medical direction, the bag label and your pump.