Propofol Narcotics

Cough reflex Exercise caution when using narcotic analgesics postoperatively and in patients with pulmonary disease because cough reflex is suppressed. Intraoperative awareness Intraoperative awareness has been reported in patients younger than 55 years of age when remifentanil has been administered with propofol infusion rates of 75 mcg/kg/min or less. 

Propofol [pro POF ol] is an IV sedative/hypnotic used in the induction or maintenance of anesthesia. Onset is smooth and occurs within about 40 seconds of administration. Supplemenation with narcotics for analgesia is required. While propofol facilitates depression in the CNS, high plasma levels can cause excitation. Propofol decreases blood pressure without depressing the myocardium. It also reduces intracranial pressure. 

CNS depressants (e.g., hypnotics/sedatives, inhalational anesthetics, narcotics) can increase the CNS depression induced by propofol. Morphine premedication with nitrous oxide decreases the necessary propofol maintenance infusion rate and therapeutic blood concentrations when compared to nonnarcotic (e.g., lorazepam) premedication. In addition, the induction dose requirements of propofol may be reduced in patients with IM or IV premedication, particularly with narcotics alone or in combination with sedatives. These agents may increase the anesthetic effects of propofol and may also result in more pronounced decreases in systolic, diastolic, and mean arterial pressures and cardiac output. 

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