Propofol
Propofol is an intravenous anesthetic.
Group
Intravenous anesthetic
Mechanism of Action
Enhances inhibitory GABA-associated neurotransmission, producing rapid hypnosis and anesthesia.
Dose Rates
Dogs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Anesthetic induction | 5.5–7.6 mg/kg | IV | Once | Reported label induction range, injected over 30-60 seconds. |
| Anesthetic induction | 4 mg/kg | IV | Once | Common lower clinical induction dose. |
| Anesthetic induction | 3 mg/kg | IV | Once | Premedicated dogs; reduce further as clinically indicated. |
| Incremental anesthetic supplementation | 0.5–1 mg/kg | IV | As needed | |
| Anesthetic maintenance bolus | 1–3 mg/kg | IV | As needed | |
| Anesthetic infusion — Loading | 5–6 mg/kg | IV | Once | |
| Anesthetic infusion — Maintenance | 100–450 mcg/kg/min | IV | Continuous | Unpremedicated patients may require up to 600 mcg/kg/min; titrate with full anesthesia monitoring. Reported alternative mg/hour upper endpoint is not exactly equivalent. |
| Status epilepticus — Loading | 1–6 mg/kg | IV | Once | To effect. |
| Status epilepticus — Maintenance | 0.1–0.6 mg/kg/min | IV | Continuous | |
| Anesthetic sedation infusion | 0.1 mg/kg/min | IV | Continuous | |
| Minor surgery infusion | 0.6 mg/kg/min | IV | Continuous | |
| Anesthetic maintenance infusion | 0.4 mg/kg/min | IV | Continuous | Adjust to depth; inadequate depth may require 1 mg/kg IV bolus then 25% rate increase. |
| Refractory status epilepticus alternative — Loading | 3–6 mg/kg | IV | Once | |
| Refractory status epilepticus alternative — Maintenance | 8–12 mg/kg/hour | IV | Continuous | Ventilatory support may be needed. |
| Premedicated induction with acepromazine and opioid | 2.3 mg/kg | IV | Once | |
| Unpremedicated induction alternative | 6.6 mg/kg | IV | Once | Give over 60 seconds; transition promptly to inhalant. |
| Refractory seizure infusion | 0.1–0.25 mg/kg/min | IV | Continuous | After titrated 1-3.5 mg/kg IV, up to 6 mg/kg if needed. Higher rate up to 0.6 mg/kg/min is described; initial course 6-12 hours then taper, maximum around 48 hours. |
| PropoFlo induction | 5.5 mg/kg | IV | Once | No premedication; table mean, titrate over 40-60 seconds. Study premedication details must be retained in the anesthesia plan. |
| PropoFlo induction | 3.7 mg/kg | IV | Once | Acepromazine; table mean, titrate over 30-50 seconds. Study premedication details must be retained in the anesthesia plan. |
| PropoFlo induction | 2.6 mg/kg | IV | Once | Acepromazine plus oxymorphone; table mean, titrate over 30-50 seconds. Study premedication details must be retained in the anesthesia plan. |
| PropoFlo intermittent maintenance | 2.2 mg/kg | IV | As needed | No premedication; give over 10-30 seconds to effect. |
| PropoFlo intermittent maintenance | 1.6 mg/kg | IV | As needed | Acepromazine; give over 10-30 seconds to effect. |
| PropoFlo intermittent maintenance | 1.8 mg/kg | IV | As needed | Acepromazine plus oxymorphone; give over 10-30 seconds to effect. |
Cats
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Anesthetic induction | 4–8 mg/kg | IV | Once | Administer slowly; approximately 6 mg/kg often suffices. Premedication reduces requirements. |
| Incremental anesthetic supplementation | 1–3 mg/kg | IV | As needed | |
| Anesthetic infusion | Reference only | IV | Reported gives 6 mg/kg IV loading then 200-300 mcg/kg/min but also labels this 0.2-0.3 mg/kg/hour. These are inconsistent by a factor of 60; clarify before calculator use. | |
| Propofol-ketamine anesthesia | Reference only | IV | Propofol 0.025 mg/kg/min plus ketamine 23-46 mcg/kg/min; combined-agent protocol retained together. | |
| Short-term surgery | 10 mg/kg | IV | Once | Give over 1 minute; reported duration 10-20 minutes. |
| Anesthetic sedation infusion | 0.1 mg/kg/min | IV | Continuous | |
| Minor surgery infusion | 0.6 mg/kg/min | IV | Continuous | |
| Anesthetic maintenance infusion | 0.4 mg/kg/min | IV | Continuous | Adjust to depth; inadequate depth may require 1 mg/kg IV bolus then 25% rate increase. |
| Refractory status epilepticus alternative — Loading | 3–6 mg/kg | IV | Once | |
| Refractory status epilepticus alternative — Maintenance | 8–12 mg/kg/hour | IV | Continuous | Ventilatory support may be needed. |
Horses
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Anesthetic induction | 2 mg/kg | IV | Once | Premedicate with guaifenesin 90 mg/kg IV or another appropriate sedative; propofol alone causes excitement and myotonus. |
Sheep
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Anesthetic induction | 4 mg/kg | IV | Once |
Goat
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Anesthetic induction | 4 mg/kg | IV | Once |
Pigs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Anesthetic induction | 2–5 mg/kg | IV | Once |
Rabbits
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Anesthetic induction | 5–14 mg/kg | IV | Once | Titrate slowly; not recommended as sole maintenance agent. |
Mice
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Anesthetic induction | 26 mg/kg | IV | Once |
Rats
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Anesthetic induction | 10 mg/kg | IV | Once |
Reptiles
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Anesthetic induction | 5–15 mg/kg | IV, IO | Once | Species-specific titration; intracardiac snake route not represented. |
Indications
- Anesthetic induction and maintenance
- Status epilepticus
- Anesthetic sedation infusion
- Minor surgery infusion
- Anesthetic maintenance infusion
- Refractory status epilepticus alternative
- Premedicated induction with acepromazine and opioid
- Unpremedicated induction alternative
- Refractory seizure infusion
- PropoFlo induction
- PropoFlo intermittent maintenance
- Anesthetic induction
Contraindications
- Correct hypotension and provide oxygen/ventilatory support.
- Do not use alone in horses; reproductive and very young canine safety are incompletely established.
Interactions
- Premedication and other anesthetics lower propofol requirements.
Adverse effects
- Apnea, respiratory depression, hypotension, involuntary movements and occasional injection pain; repeated exposure can cause feline oxidative erythrocyte injury.
Toxicity
Stop propofol for overdose-associated apnea or cardiovascular depression; maintain oxygenation, assisted ventilation and circulation.
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Propofol emulsion 10 mg/mL | Injection | 10 mg / mL | IV |
| PropoFlo propofol macroemulsion 10 mg/mL Unpreserved macroemulsion: discard after procedure or within 6 hours of opening, whichever is sooner. Do not substitute historical PropoClear microemulsion. | Injection | 10 mg / mL | IV |
Monitoring and Administration
Titrate slowly and wait for brain equilibration before repeating. Monitor ventilation, oxygenation, rhythm and pressure. Shake emulsion and use strict asepsis.
Unpreserved products: discard within 6 hours of opening. The benzyl-alcohol-preserved PropoFlo 28 formulation has a 28-day in-use period. Protect from light, do not freeze, and do not dilute below 2 mg/mL.
Premedicated dogs may need at least a 20-30% induction reduction; feline reductions of 16-24% are described, and midazolam may reduce feline requirements by up to 25%. Titrate to effect rather than applying reductions cumulatively.
With sustained feline infusions, minimize total dose/duration and monitor packed-cell volume/CBC for Heinz-body or hemolytic anemia. Rapid injection under 5 seconds increases apnea. Older PropoClear tables are formulation-specific and must not be applied to current macroemulsion products.
Embedded feline PropoClear tables concern the historical microemulsion: induction means 7.4 mg/kg without premedication, 6.2 after phenothiazine/opioid or benzodiazepine/opioid, 5.6 after alpha2 agonist; maintenance means 1.9, 2.3, 2.2 and 2.3 mg/kg respectively. These formulation-specific tables are retained only as historical context and are not interchangeable current macroemulsion instructions.
Discard separated propofol emulsion. For the unpreserved macroemulsion, discard at the end of the procedure or 6 hours after opening, whichever is sooner; preservative-containing formulations have different validated in-use periods.