Dose requirements of ICI 35,868 (Propofol, ‘Diprivan’) in a new formulation for induction of anaesthesia

Cummings, G.C.; Dixon, Jennifer; Kay, N. H.; Windsor, J. P. W.; Major, E.; Morgan, M.; Sear, J. W.; Spence, A.; Stephenson, Derek

doi:10.1111/j.1365-2044.1984.tb06425.x

Cited by 160 publications

(30 citation statements)

References 16 publications

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“…Later trials using other water and lipid based emulsions were conducted in Europe in 1983 and in the United States in 1984. These preparations were found to be as effective as Propofol in Cremophor but they were not associated with a similar rate of anaphylactic reactions [13]. In 1986 Propofol was introduced for therapeutic use as a lipid emulsion in the United Kingdom and New Zealand.…”

Section: ) Historymentioning

confidence: 99%

Propofol: A Review of its Role in Pediatric Anesthesia and Sedation

2015

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Propofol is an intravenous agent used commonly for induction and maintenance of anesthesia, procedural and critical care sedation in children. The mechanisms of action on the central nervous system involve interactions at various neurotransmitter receptors, especially gamma-aminobutyric acid A receptor. Approved for use in the United States by the Federal Drugs and Administration (FDA) in 1989, its use for induction of anesthesia in children less than 3 years of age still remains off-label. Despite its wide use in pediatric anesthesia, there is conflicting literature about its safety and serious adverse effects in particular subsets of children. Particularly as children are not “little adults”, in this review, we emphasize the maturational aspects of propofol pharmacokinetics. Despite the myriad of propofol pharmacokinetic-pharmacodynamic studies and the ability to use allometrical scaling to smooth out differences due to size and age, there is no optimal model that can be used in target controlled infusion pumps for providing closed loop total intravenous anesthesia in children. As the commercial formulation of propofol is a nutrient-rich emulsion, the risk for bacterial contamination exist despite the FDA mandating addition of antimicrobial preservative, calling for manufacturers’ directions to discard open vials after six hours. While propofol has advantages over inhalation anesthesia like less postoperative nausea and emergence delirium in children, pain on injection remains a problem even with newer formulations. Propofol is known to depress mitochondrial function by its action as an uncoupling agent in oxidative phosphorylation. This has implications for children with mitochondrial diseases and the occurrence of propofol-related infusion syndrome, a rare but seriously life-threatening complication of propofol. At the time of this review, there is no direct evidence in humans for propofol induced neurotoxicity to the infant brain; however, current concerns of neuroapoptosis in developing brains induced by propofol persist and continue to be a focus of research.

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Section: ) Historymentioning

confidence: 99%

Propofol: A Review of its Role in Pediatric Anesthesia and Sedation

2015

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“…Administration of these drugs was at the discretion of the treating physician. Sufficient sedation was defined as the administration of midazolam (Dormicum) at doses Ն0.1 mg/kg body weight (10), etomidate (Hypnomidate) at doses Ն0.2 mg/kg body weight (11), or propofol (Diprivan) at doses Ն1 mg/kg body weight (12). Sufficient analgesia was defined as the use of fentanyl (Fentanyl) at doses Ն1 g/kg body weight (13).…”

Section: Methodsmentioning

confidence: 99%

Life after death: Posttraumatic stress disorder in survivors of cardiac arrest—Prevalence, associated factors, and the influence of sedation and analgesia

Gamper¹,

Willeit²,

Sterz³

et al. 2004

Critical Care Medicine

106

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“…The end point of induction, taken as the dropping of a water-filled 20-mL syringe held between the thumb and index finger of an extended arm (13), was also assessed by the observer. The propofol or propofol/ lidocaine infusion was stopped when the syringe was dropped and general anesthesia was continued as per routine practice.…”

Section: Methodsmentioning

confidence: 99%