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IV Induction and Maintenance Agent Pregnancy: Safety in pregnancy not established; animal studies show reproductive toxicity. Should not be given to pregnant women except when absolutely necessary. Crosses the placenta and can cause neonatal depression; may be used during induced abortion (§4.6).

Propofol

Brand names: Diprivan

Propofol is a short-acting intravenous anaesthetic agent used for induction and maintenance of general anaesthesia and for procedural sedation.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Induction of general anaesthesia for surgery (adults <55 yrs): 1.5 to 2.5 mg/kg, titrated 20-40 mg every 10 seconds against response; maintenance by continuous infusion 4-12 mg/kg/h
Route: IV
Frequency: Titrated induction bolus, then continuous infusion or repeat boluses for maintenance
Maintenance of anaesthesia: continuous infusion 4-12 mg/kg/h, or repeat bolus increments of 25-50 mg according to clinical requirements. Patients over 55 yrs and ASA III/IV (especially impaired cardiac function): reduce induction to a minimum of 1 mg/kg at a lower rate (~20 mg every 10 seconds); reduce further in elderly, poor general condition, hypovolaemic or hypoproteinaemic patients, and avoid rapid bolus (cardiorespiratory depression). Sedation for diagnostic/surgical procedures (adults): 0.5-1 mg/kg over 1-5 min for onset, then infusion 1.5-4.5 mg/kg/h; supplement with 10-20 mg boluses; lower doses over 55 yrs and ASA III/IV. Supplementary analgesia is generally required. Give only by those trained in anaesthesia; not by the person performing the procedure.

Paediatric dose

Dose: 2.5 mg/kg
Route: IV
Frequency: Induction, titrated to response
Max: Not stated in source
General anaesthesia in children over 1 month: induction approx 2.5 mg/kg in patients over 8 yrs; children aged 1 month-3 years may require higher (2.5-4 mg/kg). Maintenance of anaesthesia by infusion approx 9-15 mg/kg/h (higher in younger children). Sedation for procedures (over 1 month): 1-2 mg/kg for onset, then infusion 1.5-9 mg/kg/h, supplement with boluses up to 1 mg/kg. Lower doses in ASA III/IV. NOT for ICU sedation in patients 16 years or younger (contraindicated). Verify against a children's formulary.

Dose adjustments

Renal

Caution in renal impairment (§4.4); no specific dose adjustment stated.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Paediatric weight-based calculator

General anaesthesia in children over 1 month: induction approx 2.5 mg/kg in patients over 8 yrs; children aged 1 month-3 years may require higher (2.5-4 mg/kg). Maintenance of anaesthesia by infusion approx 9-15 mg/kg/h (higher in younger children). Sedation for procedures (over 1 month): 1-2 mg/kg for onset, then infusion 1.5-9 mg/kg/h, supplement with boluses up to 1 mg/kg. Lower doses in ASA III/IV. NOT for ICU sedation in patients 16 years or younger (contraindicated). Verify against a children's formulary.

Verify in a children's formulary

Contraindications

  • Hypersensitivity to propofol, soya, peanut or any excipient
  • Sedation for intensive care in patients 16 years of age or younger (safety/efficacy not demonstrated)

Side effects

  • Local pain on induction (very common)
  • Hypotension (common)
  • Bradycardia (common; rare progression to asystole)
  • Transient apnoea during induction (common)
  • Nausea and vomiting during recovery; headache during recovery (common)

Clinical monograph

How it works

Propofol potentiates inhibitory GABA-A receptor activity in the central nervous system, producing rapid loss of consciousness with a swift, clear-headed recovery.

Prescribing in practice

  • Propofol causes dose-dependent cardiorespiratory depression including hypotension and apnoea — it must only be given by those trained in anaesthesia and airway management, with full resuscitation and monitoring equipment immediately available.
  • Strict asepsis is essential as the lipid emulsion supports microbial growth; pain on injection is common, and prolonged high-dose infusion risks propofol infusion syndrome.
  • Use with caution and reduced dosing in the elderly, hypovolaemic or haemodynamically unstable patient, and note the emulsion contains soya and egg-derived constituents.

Monitoring

Continuously monitor depth of anaesthesia, oxygenation, ventilation and haemodynamics, and observe for metabolic acidosis during prolonged infusions.

Counselling the patient

  • This is the medicine that sends you off to sleep for your operation, working within seconds.
  • You may feel a brief stinging as it goes into the vein.
  • Recovery is usually quick and clear-headed.

Evidence & guidelines

Propofol is a standard, extensively validated intravenous induction and maintenance agent in modern anaesthesia.

Reference: AAGBI Safety Guidelines; Diprivan SPC; Vasile et al. (PRIS Review); Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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