What is the propofol dosage after endotracheal (ET) intubation?

From the Guidelines

Propofol dosage after endotracheal (ET) intubation is typically 0.5-1 μg/ml. This dosage is based on target-controlled infusion (TCI) and is intended to maintain a stable level of sedation without causing over-sedation or hypoventilation 1.

Key Considerations

• The dosage may need to be adjusted based on the patient's response and the presence of concomitant opioid use, which can increase the risk of over-sedation and hypoventilation 1.
• Bolus dosing should be avoided due to the risk of over-sedation and hypoventilation, and instead, a target-controlled infusion should be used to maintain a stable level of sedation 1.
• The patient's vital signs should be closely monitored, and the dosage adjusted as needed to maintain the desired level of sedation while minimizing adverse effects.

Dosage Adjustments

• The dosage can be adjusted within the range of 0.5-1.5 μg/ml, with caution exercised when exceeding 1.5 μg/ml due to the increased risk of over-sedation and hypoventilation 1.

From the FDA Drug Label

In adults, anesthesia can be maintained by administering propofol injectable emulsion by infusion or intermittent IV bolus injection The patient's clinical response will determine the infusion rate or the amount and frequency of incremental injections. Continuous Infusion Propofol injectable emulsion 100 mcg/kg/min to 200 mcg/kg/min administered in a variable rate infusion with 60% to 70% nitrous oxide and oxygen provides anesthesia for patients undergoing general surgery Maintenance by infusion of propofol injectable emulsion should immediately follow the induction dose in order to provide satisfactory or continuous anesthesia during the induction phase. During this initial period following the induction dose, higher rates of infusion are generally required (150 mcg/kg/min to 200 mcg/kg/min) for the first 10 to 15 minutes Infusion rates should subsequently be decreased 30% to 50% during the first half-hour of maintenance. Generally, rates of 50 mcg/kg/min to 100 mcg/kg/min in adults should be achieved during maintenance in order to optimize recovery times.

The propofol dosage after endotracheal (ET) intubation is 100 mcg/kg/min to 200 mcg/kg/min for maintenance of anesthesia, with initial rates of 150 mcg/kg/min to 200 mcg/kg/min for the first 10 to 15 minutes, and subsequent decreases to 50 mcg/kg/min to 100 mcg/kg/min for maintenance 2.

From the Research

Propofol Dosage After Endotracheal Intubation

• The dosage of propofol after endotracheal intubation can vary depending on the specific study and patient population 3, 4, 5, 6.
• In one study, propofol was administered at a rate of 0.15 mg/kg/min for maintenance of anesthesia after induction with 2 mg/kg propofol 5.
• Another study used a continuous intravenous infusion of propofol at a rate of 0.05-0.2 mg/kg/min, supplemented with nitrous oxide, after induction with 2 mg/kg propofol 6.
• A study on the optimal dose of remifentanil for acceptable intubating conditions during propofol induction without neuromuscular blockade used a propofol dose of 2.0 mg/kg for induction 7.
• The effective dose of propofol for maintenance of anesthesia after endotracheal intubation is not explicitly stated in the provided studies, but the infusion rates mentioned above can be used as a reference 3, 4, 5, 6.

Factors Affecting Propofol Dosage

• The dosage of propofol can be affected by factors such as patient age, weight, and medical history 4.
• The use of other anesthetic agents, such as nitrous oxide and remifentanil, can also impact the required dosage of propofol 6, 7.
• The specific formulation of propofol used can also have an effect on the dosage required, with sulfite-containing propofol potentially having different effects than EDTA-containing propofol 5.