The side effects of propofol

The side effects of propofol include pain at the injection site, anaphylaxis, decreased blood pressure, arrhythmia, respiratory depression, propofol output syndrome, convulsive reaction, potential addiction and abuse, infection, slight decrease in blood potassium, etc.

Side effects of propofol:

1. Injection site pain: The injection site pain can occur immediately or later. The mechanism is still unclear. Propofol, like many phenolic drugs, strongly stimulates the skin, mucous membrane and vascular intima, causing pain.

2. Allergic reaction: The allergic reaction caused by propofol may be related to the genetic allergic history, drug and other allergic history, and histamine release caused by propofol. The clinical manifestation of anaphylaxis caused by propofol is large red plaques or papules in the chest region, which generally appear a few minutes after intravenous propofol induction. In very few cases, anaphylactic shock will occur, mainly manifested as chest tightness, dyspnea, urticaria, and decreased blood pressure. In severe cases, it can cause laryngeal edema and bronchospasm, seriously endangering the lives of patients.

1. Reduced blood pressure: Propofol inhibits cardiovascular system to varying degrees. The occurrence of hypotension is related to the reduction of peripheral vascular resistance, cardiac preload, sympathetic nerve activity and myocardial contractility. The results showed that propofol induced hypotension was also related to the injection speed, dose and the effect on central nervous system.
2. Arrhythmias: Propofol can inhibit the baroreflex that causes an accelerated heart rate, and its inhibition is greater than that of the parasympathetic nerve, resulting in a slowing down of the heart rate of some patients after the application of propofol, even up to 50 times/minute. At the same time, propofol also has the potential role of inducing sinus tachycardia, ventricular premature contraction and ST segment depression.
3. Respiratory depression: clinical application of propofol is easy to cause respiratory depression of patients. Even the induced dose of propofol will reduce the patient's respiratory rate and tidal volume, and even cause apnea, the amplitude and frequency of which are greater than other similar intravenous anesthetics.
4. Propofol infusion syndrome: RIS is the most harmful drug used by propofol. Since the emergence of PRIS, the success rate of treatment has been low, mainly focusing on prevention. At present, the infusion time of propofol is too long, and the infusion speed exceeds 5mg/kg, which will lead to propofol output syndrome.
5. Convulsive reaction: Propofol has both anticonvulsant effect and nerve excitability, but its nerve excitability is low, and it is generally transient when anesthesia recovers.
6. Addiction: propofol activation γ Aminobutyric acid receptor A can cause physiological and psychological euphoria, so there is a potential risk of addiction and abuse.
7. Infection: Propofol solution contains glycerin, purified lecithin, soybean oil and water, which is suitable for the growth of most bacteria and fungi.
8. Others: Propofol has no obvious hypoglycemic effect after one-time intravenous administration, but it has a certain effect on hypoglycemia. The hypoglycemic effect is most obvious at 7 min, reaching 0.34 ± 0.06 μ/ L。 Therefore, patients with hypokalemia should pay attention to blood potassium monitoring before using propofol, and supplement potassium when necessary.