How common is propofol infusion syndrome?

The incidence of PRIS is unknown, but it is probably less than 1 percent. Mortality is variable but high (33 to 66 percent). Treatment involves discontinuation of the propofol infusion and supportive care.

When does propofol infusion syndrome develop?

The syndrome is not well understood but appears to be related to long-term (>48 hours), high-dose (>5 mg/kg/h) propofol infusion. The main features consist of cardiac failure (sudden onset of bradycardia), rhabdomyolysis, severe metabolic acidosis, and renal failure.

How long does propofol infusion syndrome last?

Its use was approved by the food and drug administration (FDA) in November 1989. Propofol administration has many important advantages, such as a rapid onset of action—within seconds after administration—and a short duration of action—up to 15 minutes [2].

What is propofol related infusion syndrome?

Propofol-related infusion syndrome (PRIS) is a rare yet often fatal syndrome that has been observed in critically ill patients receiving propofol for sedation. PRIS is charac- terized by severe unexplained metabolic acidosis, arrhythmias, acute renal failure, rhabdomyolysis, hyperkalemia, and cardiovascular collapse.

What medication reverses propofol?

Physostigmine reverses propofol-induced unconsciousness and attenuation of the auditory steady state response and bispectral index in human volunteers. Anesthesiology.

What is the antidote for propofol overdose?

In summary, we have shown that physostigmine reverses the propofol-induced unconsciousness and associated depression of the ASSR and BIS in human volunteers. The reversal of the unconsciousness and depression of the ASSR and BIS was blocked by pretreatment with scopolamine.

When should propofol triglycerides be checked?

Propofol is considered a first-line sedative at our institution in mechanically ventilated patients who require continuous sedation. The maximum dose allowed in the ICU is 83 µg/kg/min, and it is recommended to monitor triglyceride levels every 48–72 hours for patients requiring prolonged infusions.

How is propofol infusion syndrome treated?

Management of overt propofol infusion syndrome requires immediate discontinuation of propofol infusion and supportive management, including hemodialysis, hemodynamic support, and extracorporeal membrane oxygenation in refractory cases.

Can narcan reverse propofol?

Reversal agents exist for each class of drugs used in sedative procedures (unfortunately, propofol does not have a reversal agent). The current reversal agents, flumazenil for benzodiazepines and naloxone for opioids, work by binding to the same receptors that the sedative or opiate drug attaches to.

When is propofol contraindicated?

Propofol Injectable Emulsion is contraindicated in patients with a known hypersensitivity to propofol or any of Propofol Injectable Emulsion components. Propofol Injectable Emulsion is contraindicated in patients with allergies to eggs, egg products, soybeans or soy products.

What happens if you give propofol too fast?

OVERDOSAGE: Rapid administration or accidental overdosage of propofol may cause cardiopulmonary depression. Respiratory arrest (apnea) may be observed. In cases of respiratory depression, stop drug administration, establish a patent airway, and initiate assisted or controlled ventilation with pure oxygen.

Does narcan reverse propofol?