PROPOFOL IN VETERINARY PRACTICE - A REVIEW

Ankur Sharma*
Division of Veterinary Surgery and Radiology
Faculty of Veterinary Sciences and Animal Husbandry, SKUAST-J
R.S.Pura, Jammu (J&K)-181102 India

Keywords: Propofol | Anaesthetic | Veterinary |

Abstract

Propofol (Diprivan®, Rapinovet®, Propoflo®), an alkyl phenol hypnotic has been investigated as a widely used intravenous anaesthetic in dogs and cats. But little research has been carried out on ruminants in India. It is generally considered safe for use in animals with renal or hepatic disease and also most instances of mild to moderate heart disease with appropriate monitoring and support.

Propofol is a short-acting, rapidly metabolized agent which is characterized by a virtual lack of any cumulative effect and by rapid recovery after its administration in bolus doses or by continuous infusion. It provides a reliable, rapid and smooth induction of anaesthesia, adequate hypnosis and analgesia for surgical interventions and minimal suppression of vital organ functions. Moreover recovery is observed to be rapid, uncomplicated and complete.

History

Studies conducted in the early 1970s to develop new and safe injectable anaesthetic demonstrated that some derivatives of phenol had hypnotic properties. This research resulted in the development of a new molecule, 2, 6-di-isopropyl phenol. The first clinical trial conducted by Kay and Stephenson (1980) confirmed the potential of this compound as an injectable anaesthetic.
Over the last 10-15 years, propofol (2, 6-di-isopropylphenol) has become increasingly popular as an intravenous anaesthetic for the induction as well as maintenance of general anaesthesia. It is mainly because of the smooth and fast recovery from propofol-induced anaesthesia whether it is given as bolus or continuous infusion (Hall and Chambers, 1987).
The first formulation introduced in the clinical trials was prepared with polyoxethylated castor oil (cremaphor). It was produced as 1 percent solution of propofol in 16 per cent cremaphor. However, some undesirable side effects viz. pain on injection (Major et al., 1981) and anaphylactic reactions (Dye and Watkins, 1980) were observed during early clinical studies with this preparation. These responses led to the development of an alternative formulation for propofol.

Usage

Propofol is being widely used as an anaesthetic drug in human patients (Andrews et al., 1997). However, the drug does not produce complete analgesia and muscle relaxation. For this, it may be used along with drugs having analgesic and adequate muscle relaxant properties.
It is demonstrated to possess anticonvulsant properties which are similar to those of thiopentone (Lowson et al., 1990; DeRiu et al., 1992). It gives a strong protection against lignocaine or pentylene-tetrazole induced epilepsy and consistently reduces the duration of seizure in electroconvulsive therapy (Borgeat, 1997). The use of propofol induction and infusion maintenance in patients with hepatic schistosomiasis has also been justified. (Fandy et al.,1994).

Pharmacology (Mechanism of action)

Propofol, an alkyl phenol derivative (2, 6¬ di-isopropyl phenol) is an anaesthetic drug, characterized by rapid induction, satisfactory sedation with good haemodynamic stability and fast, unexcited recovery (Watkins et al., 1987; Weaver and Raptopoulos, 1990).
The exact mechanism of its action is not yet been fully elucidated; however, evidence suggests that it acts by enhancing the function of the gama amino butyric acid (GABA) receptor. Propofol has been reported to evoke the chloride current in central neurons at clinically relevant concentration and to activate the GABA receptor- chloride ionophore complex. Unlike barbiturates, propofol is not anti-analgesic and does not increase the sensitivity to somatic pain in humans. Propofol posseses moderate analgesic properties as demonstrated in humans (Briggs et al., 1982).
Propofol, a weak organic acid with a pKa of 11.0 remains almost entirely unionized at pH 7.4. It gets extensively bound to plasma albumin, leaving a free fraction of only 2 per cent over a wide range of drug concentrations. After an initial bolus of propofol, plasma level decline rapidly, mainly because of redistribution of propofol from the brain and other highly perfused tissues into less perfused sites (e.g. muscles and fat). Propofol gets completely and rapidly metabolized to the sulphate and glucuronic conjugates having no hypnotic properties, and are mainly eliminated by the kidneys. Less than one per cent of the drug is excreted unchanged in the urine (Bowman, 1989).
Rapid onset of action is caused by rapid uptake of propofol into the central nervous system. The short duration of action and rapid smooth emergence results from its rapid redistribution from the brain to other tissue and efficient elimination from plasma by metabolism (Zoran et al., 1993).
Propofol is rapidly metabolized, with clearance approximately 10 times faster than that of thiopentone sodium in humans (Shafer, 1993). It posseses a large volume of distribution as would be expected from its lipophilic nature. The metabolic clearance of propofol in human exceeds hepatic blood flow, which has led to the conclusion that this agent is also metabolized by extrahepatic sites (Shafer, 1993). Evidence to this hypothesis is provided by the detection of propofol metabolism after administration of propofol during anhepatic phase of orthotropic liver transplantation in human patients (Veroli et al., 1990).

Composition/ Formulation

The present formulation consists of 1 per cent propofol in intralipid, a parental nutritional agent consisting of 10 per cent soybean oil, 2.25 per cent glycerol and 1.2 per cent purified egg phosphate. It has a pH of 7 and appears as a slightly viscous milky white substance. It is stable at room temperature and is not light sensitive. If a dilute solution of propofol is required, it is compatible with 5 per cent dextrose in water (Lumb and Jones, 1996). As the vehicle is capable of supporting bacterial growth, aseptic conditions are to be maintained in removing propofol from either ampoules or vials (Andrews et al., 1997).

Dosage and Route of Administration

Propofol is to be administered intravenously only. Oral administration will not have any effect because of its rapid metabolism, whereas, intramuscular injections do not produce a state of anaesthesia. It can be diluted for continuous infusion in 5 per cent dextrose, but it should not be diluted to a concentration less than 2 mg/ml (Weaver and Raptopoulos, 1990).
It is difficult to intubate goats which receive propofol less than 3.80 mg/kg b.wt., whereas, intubation is achieved easily after administration of propofol @ 5 mg/kg (Pablo et al., 1997). Dogs are easily intubated when propofol follows medetomidine injection whereas it is not possible with propofol alone at 4 mg/kg b.wt. (Thurmon et al., 1995). Horses are easily intubated after administration of propofol with guaifenesin (Aguiar et al., 1993).
Induction dose of propofol without premedication is found to be slightly higher in buffalo calves as compared to 5.55 mg/kg in dogs (David, 1992) 5 mg/kg in sheep (Zama et al., 2003b) and 4 mg/kg in goats (Reid et al., 1993).
Propofol administered intravenously in a regimen of 0.44 mg/kg/min in sheep gives good muscle relaxation, anaesthesia and analgesia. (Brzeski et al., 1994).
Administration of propofol by either Repeat Bolus Infusion or Continuous Infusion technique provides rapid anaesthetic induction and recovery with very infrequent occurrence of unusual reactions in local dogs premedicated with xylazine. (Adetunji et al, )
Propofol anaesthesia maintained by either continuous infusion or repeated bolus injections requires high infusion rates in clinical studies to prevent motor response to somatic noxious stimuli. Lower infusion rates produces continuous sedation without anaesthesia (Vuyk et al., 1990).

Propofol in Veterinary Anaesthesia

In veterinary practice the use of propofol as a sole anaesthetic or in combination with tranquilizers, barbiturates, opioids and inhalant anaesthetics is reported in dogs (Funkquist et al.,1997; Bayan et al., 2002), cats (Cassu et al., 2003; Mendes and Selmi, 2003), sheep ( Singh et al., 2003) and goats (Reid et al.,1993; Singh et al., 2003) for short procedures (5-10 min) such as examination of mouth and ear flushes, diagnostic ultrasonography, tumour removal, castration, ovariohysterectomy, biopsies, abscess drainage, suturing of small laceration and transtracheal aspiration. However, little work has been done on the anaesthetic use of propofol in large ruminants (Genccelep et al., 2005).
Propofol produces effective general anaesthesia in different domestic animals either alone (Duke et al., 1997; Lin et al., 1997; Carroll et al., 1998; Bayan et al., 2002; Zama et al., 2003b; 2005) or in combination with acetyl promazine (Thibaut et al., 2002), diazepam (Kelawala et al., 1993), diazepam-ketamine (Flaherty et al., 1997), ketamine (Epstein et al., 2002), xylazine (Kim and Jang, 1999), medetomidine (Amarpal et al., 2002), detomidine (Matthews et al.,1999), thiopentone sodium (Ko et al., 1999), isoflurane (Funkquist et al., 1997) and halothane (Bufalari et al., 1998).
Induction of anaesthesia is rapid and smooth after administration of propofol alone in goats (Reid et al., 1993), sheep (Zama et al., 2003b, Singh et al., 2003), buffalo calves (Zama et al., 2005, camel (Fahmy et al., 1995), ponies (Flaherty et al., 1997) and dogs (Bayan et al., 2002) or in combination with diazepam-xylazine in camels (Fahmy et al., 1995), with medetomidine in ponies (Bettschart et al., 2001a), with detomidine-guaifenesin in equines (Aguiar et al., 1993), with inhaled anaesthesia (Bufalari et al., 1998) and with diazepam-etomidate (Guzel et al., 2006) in dogs. Propofol is safe and suitable drug for maintenance of anaesthesia in lions (Epstein et al., 2002).
Propofol is safe and valid anaesthesia for dogs irrespective of anaesthetic risk and type of surgery (Redondo et al., 1999). Yoo et al., (2002) observed propofol better than thiopentone sodium as an anaesthetic induction agent in dogs and its administration as continuous infusion is found to be superior to intermittent injections. Survival rate of puppies is higher after caesarian section in bitches induced general anaesthesia with propofol compared with thiopentone sodium (Funkquist et al., 1993 & 1997).
Alpha-2 adrenoceptor agonists (xylazine, medetomidine, detomidine) and benzodiazepines (diazepam, midazolam and zolazepam) may help in evolving anaesthetic combinations which possess properties desirable for an ideal general anaesthetic (Singh, 2003a). Anaesthesia with propofol can be successfully induced after premedication with alpha-2 agonists in dogs (Thurmon et al., 1995; Kim and Jang, 1999), horses (Matthews et al., 1999), sheep (Lin et al., 1997) and goats (Caroll et al., 1998; Amarpal et al., 2002). Propofol anaesthesia after benzodiazepines premedication is also reported in dogs (Kim et al., 1999; Stegmann and Bester, 2001), cats (Weaver and Raptopoulos, 1990), goats (Kelawala et al., 1991, 1993) and camels (Fahmy et al., 1995).

Premedication with Propofol anaesthesia

Premedication with acetylpromazine, papaveretum, diazepam, pethidine, atropine and scopolamine do not affect recovery times of propofol in dogs and cats (Weaver and Raptopoulos, 1990). Prolongation of recovery time is reported when propofol follows xylazine in dogs. (Kim and Jang,1999) reported Quick, smooth and excitement free recovery is reported in camels (Fahmy et al., 1995), ponies (Flaherty et al., 1997 and Bettschart et al., 2001a). Undesirable effects during the recovery of dogs given tiletamine, zolazepam and propofol is observed (Cullen and Reynoldson, 1997). Recovery quality and recovery times of propofol and 1:1 mixture of propofol and thiopentone sodium are found superior to thiopentone sodium alone in dogs (Ko et al., 1999).

Alpha-2 adrenoreceptor agonists in combination with propofol

Anaesthesia with propofol has been studied after premedication with medetomidine in dogs (Hellebreakers and Sap, 1997; Scabell et al., 1999), goats (Caroll et al., 1998; Amarpal et al., 2002) and ponies (Bettschart et al., 2001a), whereas, detomidine is used as pre-anaesthetic to propofol anaesthesia in horses (Mathews et al., 1999; Aguiar et al., 2002).
Combination of xylazine and propofol is used to induce surgical anaesthesia in dogs (Kim and Jang, 1999; Cullen and Reynoldson 1993), cats (Robinson et al., 1995), sheep (Lin et al., 1997), goats (Amarpal et al., 2002) and horses (Mama et al, 1996).
Comparative duration of action and cardiopulmonary effects of propofol alone, and xylazine plus propofol is reported where xylazine premedication prolonges propofol anaesthesia in dogs. (Cullen and Reynoldson, 1993).
It is observed that administration of propofol (2 mg/kg IV) as a bolus injection, 10 min after medetomidine (15 or 30 μg/kg) induces satisfactory anaesthesia in dogs and endotracheal intubation is easy. Recovery from anaesthesia is rapid and smooth with both drug dose regimens. (Thurmon et al., 1994 and 1995)
Anaesthetic duration is shorter in dogs when propofol is given alone but prolonges when medetomidine is combined, though respiratory depression is observed with both. (Bufalari et al., 1996).
Propofol produces effective general anaesthesia in combination with ketamine and medetomidine in dogs. (Hellebrekers and Sap, 1997)
Loss of toe-web needle prick response, duration of anaesthesia and recovery time is dependent on premedication dose of xylazine in dogs anaesthetised with propofol. ( Kim and Jang, 1999).
Detomidine-propofol anaesthesia is not suitable for surgical procedures in horses, if dorsal recumbency is necessary and supplemental oxygen is not available. (Mathews et al.,1999)
Infusion of a combination of medetomidine and propofol is found to be suitable for prolonged anaesthesia in ponies. This combination causes increased mean paCO2 and decreased paO2. (Bettschart et al., 2001a)
Propofol at an average dose of 5.65±0.39mg/kg b.wt. produces anaesthesia for 6.25±1.25min in goats premedicated with medetomidine (10 µg/kg IV) and the animals are able to walk with assistance in 14.75±1.55min. A significant reduction in propofol induction dose is observed after xylazine premedication. (Amarpal et al., 2002)
Propofol following medetomidine premedication has been reported to produce good muscle relaxation and analgesia in dogs (Thurmon et al., 1995) and in goats (Carroll et al., 1998). Propofol bolus followed by its intravenous infusion produces good surgical anaesthesia in sheep (Lin et al., 1997; Zama et al., 2003b). Detomidine-propofol produced good surgical anaesthesia and muscle relaxation in horses (Aguiar et al., 1993).

Benzodiazepines in combination with propofol

Propofol anaesthesia with diazepam has been evaluated in dogs (Marisco et al., 1997), cats (Weaver and Roptopoulos, 1990), goats (Kelawala et al., 1991, 1993) and camels (Fahmy et al., 1995). Propofol is used to induce surgical anaesthesia in dogs premedicated with zolazepam (Cullen and Reynoldson, 1997) and midazolam in dogs (Kim et al., 1999).
Significant increase in total plasma protein, albumin and blood glucose is observed but no significant change in blood urea nitrogen and creatinine occurs during diazepam-propofol-ketamine anaesthesia in goats. (Kelawala et al. 1991, 1993)
Propofol in combination with xylazine and diazepam is safe, convenient and practical anaesthesia for camels. (Fahmy et al. 1995)
Diazepam-thiopentone sodium induces greater number of arrhythmias than diazepam-propofol in dogs. (Marisco et al. 1997)
Premedication effects of intravenously administered midazolam before propofol - isoflurane induction of anaesthesia in bitches undergoing ovariohysterectomy decreases the induction dose of propofol to 7.4 mg/kg instead of 9.5 mg/kg and is associated with adverse respiratory effects. (Stegmann and Bester, 2001)
Rapid and smooth anaesthesia without any untoward cardiovascular effect is observed in dogs following intravenous administration of diazepam @ 0.5 mg/kg, propofol @ 4 mg/kg and etomidate @ 2 mg/kg. Electrophysiological changes and oxygen saturation are found to be within the normal physiological range. (Guzel et al., 2006)

Monitoring of anaesthetic depth

Sluggish to absent corneal reflex is observed after induction of propofol anaesthesia in calves. (Genccelep et al., 2005). The loss of toe web needle prick response in dogs premedicated with xylazine and anaesthetized with propofol is noticed (Kim et al., 1999). Lacrimation is not seen during atropine-diazepam-propofol anaesthesia in neonatal calves. (Singh et al., 2003)
Sluggish to absent corneal reflex is observed after induction of propofol anaesthesia in calves. (Singh et al., 2003 and Genccelep et al., 2005)
In propofol anaesthesia there is rotation of eyeball in rostroventral position in light to moderate surgical anaesthesia. At the end of study, the position of eyeball is central (Hall et al., 2001). The central position of the eyeball may be due to loss of the tone of the eye muscles and increased depth of anaesthesia. (Hall et al., 2001). These findings are similar to Hall and Chamber (1987) in dogs and Genccelep et al., (2005) in cow calves, who recorded downward rotation of the eyeball during surgical anaesthesia with propofol.
On induction of anaesthesia with propofol, it is appropriate to evaluate the loss of consciousness rather than that of eyelid reflex as this reflex is lost at a lower plasma concentration than that required for loss of consciousness. (Vuyk et al., 1990).

Effect on clinical parameters

Induction of anaesthesia with propofol in animals and humans causes depression of respiratory function expressed by a decrease in tidal volume and respiratory rate. Apnea can occur, and its incidence is reported to be dependent on dose, speed of injection, concomitant premedication and the presence of hyperventilation and hyperoxia (Langley and Heel, 1988; Smith et al., 1994).
Propofol alone in dogs (Cullen and Reynoldson, 1997) or in combination with detomidine in horses (Matthews et al., 1999), halothane in dogs (Quandt et al., 1998), and detomidine-butorphanol in goats (Carroll et al., 1998) causes a decrease in respiration rate. An increase and then a subsequent decrease in respiration rate is observed after administration of propofol bolus in dogs. (Bayan et al., 2002). Propofol infusion after premedication with detomidine-ketamine produces no significant change in respiration rate in ponies (Flaherty et al., 1997). Propofol-halothane produces higher respiration rate as compared to thiopentone sodium-halothane in dogs (Redondo et al., 1999). The respiratory minute volume and respiratory tidal volume decrease significantly after induction till 15 min and gradually thereafter (Bayan et al., 2002).
Propofol alone (Kim et al., 1999) or in combination with tiletamine / zolazepam (Cullen and Reynoldson, 1997) increases heart rate in dogs, whereas, a significant decrease in heart rate is observed after administration of propofol (Brussel et al., 1989). Propofol-diazepam-etomidate produces no respiratory cessation but better oxygen saturation than propofol-diazepam alone in dogs, so it is preferred in cases carrying a risk associated with cardiovascular and respiratory systems (Guzel et al., 2006). Propofol alone produces higher heart rate than xylazine-ketamine-halothane in sheep (Lin et al., 1997) as compared to medetomidine-propofol in dogs (Hall et al., 1997) but similar cardiopulmonary effects are observed in both the groups. No significant difference is observed in heart rate in dogs anaesthetized with propofol alone and medetomidine- propofol (Thurman et al., 1995). An initial increase in heart rate and then a gradual decrease in propofol anaesthetized dogs is reported (Bayan et al., (2002).
Diazepam-thiopentone sodium induces greater number of arrhythmias than diazepam–propofol in dogs (Marisco et al., 1997). Xylazine-propofol and medetomidine-propofol combination produces bradycardia in goats which is more pronounced after premedication with medetomidine (Amarpal et al., 2002). Moderate bradycardia is also observed in dogs anaesthetized with butorphanol-propofol and acetylpromazine-butorphanol-propofol combinations (Bufalari et al., 1997).
Medetomidine-propofol in ponies (Bettschart et al., 2001b) and detomidine-butorphanol-propofol in dogs (Carroll et al., 1998) decreases the rectal temperature significantly. Rectal temperature shows non-significant decrease till 15 min and then increases gradually to premedication values in dogs (Bayan et al., 2002). No significant difference in rectal temperature is reported in dogs during propofol or medetomidine-propofol anaesthesia (Thurmon et al., 1995). A decrease in rectal temperature is observed after propofol administration in sheep ( Zama et al., 2003b)
Apnoea is a major adverse effect in dogs with propofol alone (Muir and Gadawski, 1998) or in combination with halothane (Quandt et al., 1998) and diazepam-etomidate (Guzel et al., 2006). A transient apnoea for 15-35 sec is observed in dogs with the use of propofol. (Bayan et al. 2002) Duration of apnoea increases in a dose dependent manner at dosages more than 14 mg/kg of propofol (Muir and Gadawski, 1998). Post-induction apnoea is more common when propofol-halothane is used for induction as compared to propofol alone in dogs (Lerche et al., 2000).
A decrease in respiration rate, heart rate, rectal temperature during detomidine-butorphanol-propofol anaesthesia in goats is recorded. General anaesthesia so produced is used for various surgical procedures such as castration and ovariectomy in goats. (Caroll et al.,1998).
Body temperature and Heart rate significantly decrease after propofol injection. ( Kim and Jang, 1999). Persistent coughing, jerky respiratory movements and hiccup during continuous intravenous anaesthesia using propofol is also reported (Hall and Chamber, 1987).

Effect on Haematological parameters

All haematological parameters are reported to be within the physiological limits during propofol anaesthesia in sheep (Brzeski et al., 1994). A decrease in haematocrit, haemoglobin and RBC count values and an increase in WBC count values after surgery performed under acetylpromazine-propofol anaesthesia in dogs is recorded (Gill et al.1996)
PCV is likely to fall during the first 10 min of anaesthesia in ewes. (Handel et al. 1991). A significant decrease in PCV during diazepam-propofol anaesthesia in goats is seen (Kelawala et al., 1991) whereas no significant change in PCV in dogs is also observed in a different study (Robertson et al., 1992). Xylazine used in combination with low and high doses of propofol in horses show no significant difference in PCV. (Mama et al., 1998)
No significant change in TLC, TEC and PCV values is observed when propofol is used for seven consecutive days in dogs. (Kwon et al., 1999). Similarly, no significant changes in TLC, TEC, MCV, MHC and MCHC values is noticed when xylazine-propofol combination is used for general anaesthesia in dogs. (Kim and Jang, 1999)
PCV values appear unaltered when xylazine is used in combination with low and high doses of propofol in horses. (Mama et al., 1998).

Effect on Biochemical parameters

Significant increase in BUN, TPP and albumin during xylazine-propofol anaesthesia in dogs is observed. (Kim and Jang (1999), although, no significant change in BUN and serum creatinine levels is noticed during administration of propofol anaesthesia in dogs (Kwon et al., 1999) and during diazepam-propofol-ketamine anaesthesia in goats (Kelawala et al., 1991). Atropine-medetomidine-propofol raises the levels of blood triglycerides, total bilirubin and activity of gama-glutamyl transferase in dogs (Komar et al., 1994).
A significant increase in the total plasma protein and albumin, and no significant change in blood urea nitrogen and creatinine during diazepam-propofol-ketamine anaesthesia is noticed in goats (Kelawala et al, 1991, 1993).
The AST and ALT values decrease, but remain within the clinical normal range when propofol anaesthesia is induced and maintained for seven consecutive days in dogs (Kwon et al., 1999). Slight increase in AST and protein values is reported in dogs when anaesthetized with methotrimeprazine-propofol (Aguiar et al., 1994). All blood biochemical parameters remain within physiological limits in sheep under propofol anaesthesia (Brzeski et al., 1994).
Significant increase in total protein and albumin values is noticed after propofol anaesthesia in dogs premedicated with xylazine. ( Kim and Jang, 1999).

Blood Gas and Electrolyte Changes

During a continuous two hour propofol infusion in dogs, no statistical difference in the arterial blood gas values is recorded as compared to those of isoflurane anaesthesia. The cardiac output and cardiac index are also similar. (Smith et al., 1994)
An increase in HCO-3 content and arterial blood pH after detomidine-butorphanol-propofol anaesthesia in goats is recorded (Carroll et al., 1998), whereas, a decrease in venous blood pH after propofol administration in dogs is reported (Smith et al., 1993). Cyanosis is reported using propofol alone in goats (Pablo et al., 1997) and also in combination with butorphanol in cats (Hall et al., 1999).
Propofol alone (Duke et al., 1997) and in combination with tiletamine / zolazepam (Cullen and Reynoldson, 1997), detomidine-butorphanol (Carroll et al., 1998), xylazine and detomidine (Mama et al., 1996) and medetomidine (Betteschart et al., 2001a) increases the mean paCO2 and decreases the mean paO2 in different species of animals. Hypoxaemia with decrease in paO2 is produced in ponies (Bettschart et al., 2001b) and in dogs (Cullen and Reynoldson, 1997). An increase in end expiratory CO2 partial pressure in dogs is reported with the use of medetomidine-propofol combination (Scabell et al., 1999).
Significant changes in sodium before, during and after propofol anaesthesia in calves is reported, whereas, no significant changes are reported in potassium, chloride, paO2, paCO2, and SaO2% in calves. (Genccelep et al., 2005). A decrease in pH, paO2, SaO2%, and increase in paCO2 during anaesthetic period is noticed which returns to normal 15 min after termination of propofol infusion in buffalo calves. (Zama et al., 2005)
Haemoglobin oxygen saturation (SaO2%) following propofol anaesthesia is observed to be 85.4 per cent and after etomidate administration as 88.6 per cent indicating slight hypoxemia in dogs. (Guzel et al., 2006). A decrease in blood pH 3 min after propofol administration in dogs is reported. (Ilkiw et al., 1992).

Conclusions

Propofol (Diprivan®, Rapinovet®, Propoflo®) is a versatile drug which can be given for short or prolonged sedation as well as for general anesthesia. Propofol is generally considered to be a safe form of anesthesia and is widely used as an injectable, intravenous form of anesthesia or sedation in dogs, cats and other pets. However, propofol does have the potential for side effects, making adequate monitoring and appropriate supportive care essential to the use of propofol in the clinical setting.

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First Published June 2010

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