ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Intravenous Anaesthetic Agent Pregnancy: B

Propofol (TCI / TIVA)

Brand names: Diprivan, Propofol 1%, Propofol 2%

Adult dose

Dose: Induction: 100–200 mg IV (1.5–2.5 mg/kg); TIVA maintenance: 4–12 mg/kg/h; ICU sedation: 0.3–4 mg/kg/h
Route: intravenous infusion or bolus
Frequency: continuous infusion (TIVA/sedation) or titrated bolus
Max: 6 mg/kg/h (ICU sedation — avoid >4 mg/kg/h beyond 72h due to PRIS risk)
Propofol infusion syndrome (PRIS): rare but fatal — high dose (>4 mg/kg/h) >72h in ICU with metabolic acidosis, rhabdomyolysis, cardiac failure; monitor CK and lactate

Paediatric dose

Dose: 2.5 mg/kg
Route: IV slow injection
Frequency: induction — single dose
Max: Titrated to response
Concentration: 10 mg/mL (1%); 20 mg/mL (2%) mg/ml
ICU sedation: NOT licensed <16 years — risk of PRIS reported in paediatric ICU; induction use for children ≥1 month is licensed

Dose adjustments

Renal

No dose adjustment required

Hepatic

No dose adjustment required

Paediatric weight-based calculator

ICU sedation: NOT licensed <16 years — risk of PRIS reported in paediatric ICU; induction use for children ≥1 month is licensed

Clinical pearls

  • PRIS: monitor CK, lactate, TGs if >4 mg/kg/h beyond 48h; switch to alternative if metabolic acidosis develops
  • TCI (Target Controlled Infusion): Marsh or Schnider models — Marsh preferred for obese; weight-based
  • Lipid emulsion: provides 1.1 kcal/mL — subtract from nutritional calculations in ICU patients receiving high-dose infusions

Contraindications

  • ICU sedation in children <16 years (PRIS risk)
  • Soy/egg allergy (lipid emulsion)
  • Mitochondrial disease (PRIS risk)

Side effects

  • Pain on injection (lidocaine pre-treatment reduces)
  • Hypotension
  • Apnoea
  • PRIS (high dose/prolonged ICU use)
  • Green urine (benign)
  • Hyperlipidaemia (monitor triglycerides)

Interactions

  • CNS depressants (enhanced sedation)
  • Fentanyl (synergistic — reduce doses)
  • Neuromuscular blocking agents (no interaction)

Monitoring

  • Lactate (PRIS screen)
  • CK (PRIS screen)
  • Triglycerides (if >48h or obese)
  • Blood pressure
  • Sedation score

Reference: BNFc; BNF 86; PRIS case series; RCoA guidelines; SPC Diprivan. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators