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 Pharmacology:Predominantly agonist at GABA receptor.Hypnotic, antiemetic, and anticonvulsant.No analgesic properties.98% protein bound.No active metabolites.Onset of action 1–2 minutes, duration of effect 5–10 minutes.Propofol is delivered in a fat emulsion that provides 1.1 kcal/mL. This should be considered when adjusting enteral and parenteral nutritional requirements.

 Side effects:Vasodilation and hypotension.Myocardial depression.Respiratory depression.Pancreatitis.Propofol infusion syndrome:A potentially lethal syndrome marked by metabolic acidosis, hypertriglyceridemia, and hypotension refractory to vasopressors.Believed due to mitochondrial dysfunction.Treatment is cessation of infusion and supportive.Associated with prolonged infusions of greater than 70 μg/kg/min.Incidence of propofol infusion syndrome 1%, mortality 33%.

 Recommended doses:Bolus: 0.1–0.3 mg/kg slowly.Infusion: 5–50 μg/kg/min.