It has been widely used in painless colonoscopy, but propofol has dose dependent inhibition of respiratory and circulatory system, and induction dose … Propofol can be used, many times this requires an additional physician, an anesthesiologist or anesthetist. I had my first colonoscopy at Mayo over 15 years ago and they used a sedative back then. 42 years experience Colon and Rectal Surgery. -When an opioid is used as the primary agent, propofol maintenance rates should not be less than 50 mcg/kg/min, and care should be taken to ensure amnesia. Hi Kiwi, I think they do both sedatives and Propofol for colonoscopies. Smoking is never a good idea but there is no contraindication to smoke under your present circumstances. -Avoid rapid bolus injections. -This drug contains benzyl alcohol. -Initiation and maintenance of monitored anesthesia care (MAC) sedation -Maintenance (Titrated to Clinical Response): 100 mcg/kg/min to 150 mcg/kg/min IV Have had Propofol for multiple procedures (surgery, colonoscopy, endoscopy, pain injections and rhizotomy). 50 to 100 mcg/kg/min IV (3 to 6 mg/kg/hr); av -Slow injection method: 0.5 over 3 to 5 minutes and titrated to clinical responses; when administered slowly over 3 minutes to 5 minutes, most patients will be adequately sedated, and the peak drug effect can be achieved while minimizing undesirable cardiorespiratory effects occurring at high plasma levels. -This drug has been associated with reports of bradycardia (possibly profound) and asystole. -Secondary propofol: 50 to 100 mcg/kg/min (no bolus) Colonoscopy An uncontrolled study of 60 patients evaluated dif-ferent propofol infusion rates after a fixed loading dose during colonoscopy. -Higher doses of propofol will reduce opioid requirements. MAINTENANCE OF MAC SEDATION: For hospitals, this means that patients can be discharged more quickly, PRIMARY OPIOID WITH SECONDARY PROPOFOL: INITIATION AND MAINTENANCE OF ICU SEDATION IN INTUBATED, MECHANICALLY VENTILATED PATIENTS: The elderly, debilitated, and ASA-PS III or IV patients may have exaggerated hemodynamic and respiratory responses to rapid bolus doses (see (for at least 5 minutes; subsequent increments of 5 to 10 mcg/kg/min (0.3 to 0.6 mg/kg/hr) over 5 to 10 minutes may be used until the desired clinical effect is achieved; maintenance rates of 5 to 50 mcg/kg/min IV (0.3 to 3 mg/kg/hr) or higher may be required; administration should not exceed 4 mg/kg/hr IV unless the benefits outweigh the risks Healthy 100kg male, no medical issues other than a history of OSA. Taking other medicines that make you sleepy or slow your breathing can worsen these effects. The primary endpoint was propofol requirements. will it cause an episode of vt or vf? Sedation is routinely used for colonoscopy and there is not reason to be concerned. -Induction: 50 to 100 mcg/kg/min IV Nothing should be done before explaining pros and cons and obtaining your permission. If you begin drinking the colonoscopy prep in the evening, bump up the start time a few hours earlier to prevent running to the toilet all night. -This drug reduces cerebral blood flow, intracranial pressure, and cerebral metabolism. “It is a short-acting anesthetic that has the advantage of wearing off relatively quickly,” Dr. Rock explains. However, only a few reports have described propofol TCI technique in sedation for GI endoscopy. it's this safe? COMMENTS: A prospective safety study of a low-dose propofol sedation protocol for colonoscopy. -Elderly, debilitated, or ASA III/IV patients: Most patients require 80% of the usual adult dose; a rapid (single or repeated) bolus dose should not be used. -Intensive care unit (ICU) sedation of intubated, mechanically ventilated patients, NOTE: The dosages presented are manufacturer suggested doses. 2008;(4):CD006268. -Avoid rapid bolus injections. -Safety and efficacy have not been established in patients younger than 2 months for maintenance of general anesthesia. INITIATION AND MAINTENANCE OF ICU SEDATION IN INTUBATED, MECHANICALLY VENTILATED PATIENTS: -Maintenance (Titrated to Clinical Response): 100 mcg/kg/min to 150 mcg/kg/min IV i just had a colonoscopy done a few hours ago and i want to have a cigarette. INDUCTION OF GENERAL ANESTHESIA: i'm getting propofol sedation. A lower dose is recommended for pediatric patients classified as ASA-PS III or IV. CARDIAC ANESTHESIA TECHNIQUES: COMMENTS: The elderly, debilitated, and ASA-PS III or IV patients may have exaggerated hemodynamic and respiratory responses to rapid bolus doses (see (for at least 5 minutes; subsequent increments of 5 to 10 mcg/kg/min (0.3 to 0.6 mg/kg/hr) over 5 to 10 minutes may be used until the desired clinical effect is achieved; maintenance rates of 5 to 50 mcg/kg/min IV (0.3 to 3 mg/kg/hr) or higher may be required; administration should not exceed 4 mg/kg/hr IV unless the benefits outweigh the risks The elderly, debilitated, and ASA-PS III or IV patients may have exaggerated hemodynamic and respiratory responses to rapid bolus doses (see (for at least 5 minutes; subsequent increments of 5 to 10 mcg/kg/min (0.3 to 0.6 mg/kg/hr) over 5 to 10 minutes may be used until the desired clinical effect is achieved; maintenance rates of 5 to 50 mcg/kg/min IV (0.3 to 3 mg/kg/hr) or higher may be required; administration should not exceed 4 mg/kg/hr IV unless the benefits outweigh the risks Actual doses used vary widely between patients. -Adults less than 55 years of age and classified as ASA-PS I OR II: Slow infusion/injection is recommended to avoid apnea or hypotension. -To assure adequate anesthesia, when propofol is the only agent used, ed as the primary agent, maintenance infusion rates should not be less than 100 mcg/kg/min and should be supplemented with analgesic levels of continuous opioid administration. Available for Android and iOS devices. Results: Lidocaine infusion resulted in a significant reduction in propofol requirements: 58 (47) vs 121 (109) mg (P=0.02). -Neurosurgical Patients: 100 to 200 mcg/kg/min (6 mg/kg/h to 12 mg/kg/h) IV INITIATION OF MONITORED ANESTHESIA CARE (MAC) SEDATION: The IV administration of an anticholinergic agent prior to induction, or during maintenance of anesthesia should be considered, especially in situations where vagal tone is likely to predominate or when this drug is used in conjunction with other agents likely to cause bradycardia. -Elderly, debilitated, or ASA III/IV patients: 50 to 100 mcg/kg/min IV (3 to 6 mg/kg/hr); avoid rapid boluses Intravenous lidocaine can alleviate visceral pain and decrease propofol requirements during surgery. Secondary endpoints were: number of oxygen desaturation episodes, endoscopists' working conditions, discharge time to the recovery room, post-colonoscopy pain, fatigue. The colonoscopy completion and polyp detection rates were similar to that of historical measures. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. For debilitated patients use dose for 55 years and over. The study suggests that analgo-sedation with low dose of remifentanil is a valid alternative to sedo-analgesia with propofol. The depth of sedation with MAC is sometime moderate sedation, but is usually deep sedation. Uses: Driving, or other hazardous activities should be avoided. For Adult 55 years and over. -Dosage and rate of administration should be individualized and titrated to the desired effect, according to factors including the patient underlying medical problems, preinduction and concomitant medications, age, ASA-PS classification, and level of debilitation of the patient. Forty patients undergoing colonoscopy were included in this randomised placebo-controlled study. -Elderly, debilitated, or ASA III/IV patients: 20 mg every 10 seconds (1 to 1.5 mg/kg) IV until onset of induction; rapid boluses should not be used, as this will increase the likelihood of undesirable cardiorespiratory depression including hypotension, apnea, airway obstruction, and/or oxygen desaturation