The Science Journal of the American Association for Respiratory Care

2003 OPEN FORUM Abstracts

The Use of Propofol as a means of Sedation for Intubation in the Critically Ill Patient: Our Experience.

Tate Bennett, RRT; John Davies, MA RRT; Joann Latour, PharmD; Joe Govert, MD; Neil MacIntyre, MD. Duke University Medical Center, Durham, NC

INTRODUCTION: Studies suggest that the use of Propofol decreases pharyngeal and laryngeal reactivity and muscle tone enough to allow tracheal intubation. Hypotension is a know side effect of propofol post intubation. We developed a sedation protocol for intubation using Propofol and monitored its effectiveness and incidence of hypotension.

Methods: The protocol required adequate IV access with pre-mixed dopamine (800mg/250mls) at the bedside. Propofol 40 mg IV with additional 20-40 mg boluses every 1 minute up to a maximum of 2 mg/kg was used to achieve adequate sedation prior to intubation. We monitored blood pressure immediately before intubation, immediately after intubation, 5 minutes after intubation, and 15 minutes after intubation. We also monitored the amount of drug required and vasopressor use in 46 patients.

RESULTS:
 Mild hypotension was observed when Propofol was used for sedation. The maximum drop in blood pressure was seen 5 minutes post intubation in the > 80 mg group (-15%). Lower doses of Propofol were associated with a lesser degree of hypotension. No patients experience life threatening hypotension. Vasopressor use was required in only 24% of both dose dose groups. 

Amount of Propofol Mean BP Immediately After Intubation Mean BP 5 Minutes post Intubation Mean BP 15 Minutes Post Intubation Vasopressor Use Required
0 - 80 mg (52 + 32) -9% -5% -6% 7/29 = 24%
> 80 mg (135 + 125) -13% -15% -14% 4/17 = 24%
Total (83 + 177) -9% -8% -9% 11/46 = 24%



CONCLUSION: The use of propofol as a sedating agent for endotracheal intubation is associated with mild hypotension. However, because the effect was mild, we deemed our protocol effective and safe. 

You are here: RCJournal.com » Past OPEN FORUM Abstracts » 2003 Abstracts » The Use of Propofol as a means of Sedation for Intubation in the Critically Ill Patient: Our Experience.