Propofol: an overview of its risks and benefits

With little room for error and recent reports of abuse and deaths, propofol, a commonly used general anesthetic induction agent, has provoked considerable concern and has stirred debate regarding its classification and how care should be rendered. The drug, when abused, presents a risk for psychological dependence, and studies have indicated an increase in the rate of propofol abuse, particularly among individuals in academic anesthesia programs. When used for sedation, propofol can pose significant risks for cardiac and respiratory complications, making it crucial that the administration of this drug be provided by a practitioner who is well trained in general anesthesia. With an attractive pharmacokinetic profile of rapid onset and offset, propofol has a place in medical and dental care. When determining whether to administer propofol to patients, practitioners should bear in mind certain precluding factors, such as allergies to egg and soy. The narrow margin for error, the lack of a reversal agent, and risk for death make diligent and vigilant care imperative.