プロポフォール

動物種別の用量

投与経路

禁忌

• Hypersensitivity to propofol or any component of the product
• Patients where general anesthesia or sedation is strictly contraindicated
• Use of benzyl alcohol-preserved formulations for maintenance of anaesthesia via continuous rate infusion (CRI)

有害事象

• Transient respiratory depression and apnea (especially with rapid IV administration)
• Arterial hypotension and bradycardia
• Cyanosis (secondary to apnea)
• Seizure-like clinical signs during induction (paddling, opisthotonus, myoclonic twitching)
• Histamine release and rare anaphylactoid reactions
• Cats (with repeated/prolonged use): Heinz body anemia, slowed recovery, anorexia, lethargy, diarrhea
• Apnoea (especially with rapid injection)
• Cyanosis
• Bradycardia
• Severe hypotension
• Muscle rigidity and tremors (dogs)
• Paradoxical muscle movements (dogs)
• Heinz body anaemia (cats, with repeated daily use)
• Pain on IV injection

薬物相互作用

• Inhalation Anesthetics (halothane, isoflurane) · Propofol serum concentrations may be increased; propofol induction may require higher initial inhalant concentrations due to rapid recovery.
• Local Anesthetics · Propofol dosage requirements for sedation or hypnosis may be reduced.
• Anticholinergics · Propofol-induced bradycardia may be exacerbated, particularly when opiate premedicants are used.
• Chloramphenicol · May decrease clearance of propofol and increase recovery times.
• Clonidine · When used as a premed, may reduce propofol dosage requirements.
• CNS Depressants (acepromazine, diazepam, etc.) · Increased sedative, anesthetic, and cardiorespiratory depression possible; propofol dose should generally be reduced by ~25%.
• Hepatic P-450 Inhibitors (cimetidine, ketoconazole) · May potentially increase recovery times associated with propofol (especially significant in cats).
• Fentanyl · Increased risk for bradycardia.
• Medetomidine · Hypoxemia may occur when propofol is used after medetomidine; dosage adjustments and adequate monitoring required.
• Metoclopramide · May reduce the propofol dose required for induction by 20-25%.
• Midazolam · Synergistic effects; midazolam plasma concentrations may be increased up to 20%.

モニタリング

• Level of anesthesia/CNS effects
• Respiratory rate, rhythm, and depth (monitor for apnea/cyanosis)
• Cardiovascular status (cardiac rate/rhythm, blood pressure, pulse oximetry)
• Respiratory rate, rhythm, and depth (capnography recommended)
• Heart rate and rhythm (ECG)
• Blood pressure
• Oxygen saturation (SpO2)
• Depth of anaesthesia

過量投与

Overdosages are likely to cause **significant respiratory depression** (apnea) and potentially severe **cardiovascular depression** (hypotension, bradycardia). **Treatment:** 1. Immediately discontinue propofol administration. 2. Establish an airway and provide **artificial ventilation with 100% oxygen**. 3. Administer symptomatic and supportive treatment for cardiovascular depression (e.g., intravenous fluid therapy, vasopressors, anticholinergics like atropine or glycopyrrolate).