Sedation, analgesia and paralysis
Propofol (Diprivan) drip
Diprivan
Dosing
| Start | 5 mcg/kg/min (0.3 mg/kg/h) |
|---|---|
| Titrate | 5–10 mcg/kg/min every 5–10 minutes to the sedation goal |
| Maximum | 50 mcg/kg/min usual; over 5 mg/kg/h (83 mcg/kg/min) for over 48 hours raises PRIS risk (label; some sources use 4) |
| Common bags | 1,000 mg in 100 mL (10 mg/mL) |
| Dose units | mcg/kg/min, mg/kg/h |
Line and administration
- Lipid: change tubing every 12 hours; aseptic technique
- Its 1.1 kcal/mL counts toward nutrition
Watch for
- Hypotension
- Triglycerides
- PRIS: acidosis, rhabdomyolysis, high K, arrhythmia
Propofol: full drug monographIndications, mechanism, pharmacokinetics, cautions and every dose the app lists.
In the one-pagers
- Sedation, Pain and Delirium ScalesPADIS Guideline Key Points: Propofol or dexmedetomidine over benzodiazepines (2018). 2025: dexmedetomidine over propofol in ventilated adults if light sedation or less delirium is the priority. Dexmedetomidine is not for deep sedation; consider another agent if bradycardia risk is high.
- ICU Nutrition and RefeedingHow much: week 1 vs later: Count hidden calories: propofol 1.1 kcal/mL, clevidipine 2 kcal/mL (labels), D5W 170 kcal/L, CRRT citrate
- Airway and RSIRSI drugs: Propofol: 2–2.5 mg/kg; 1–1.5 if frail: About 40 s: Hypotension, apnea
- Asthma and COPD ExacerbationsIntubating severe asthma: Rapid sequence: ketamine 1–2 mg/kg (bronchodilates, less hypotension) or propofol, with rocuronium 1–1.2 mg/kg or succinylcholine
- Preventing ICU InfectionsCLABSI: insertion and line care: Tubing: continuous sets 96 h to 7 days; blood or lipids within 24 h; propofol 12 h (label)
- Right Heart Failure and Pulmonary HypertensionIntubation and home prostacyclin: Etomidate or reduced-dose ketamine; avoid propofol boluses; keep apnea short.
Practice Sedation, Pain and Delirium Scales questions free123 exam-style questions with rationales on the topic where propofol comes up most. No account or download needed.
Other sedation, analgesia and paralysis
- Dexmedetomidine
- Midazolam
- Fentanyl
- Cisatracurium
- Ketamine
- Hydromorphone
- Rocuronium
- Vecuronium
- Pentobarbital
- Remifentanil
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For education and exam preparation only. Follow your institution’s protocols. Study aid: check every dose against the order, the bag label, your pump library and your institution's protocol.