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Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

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Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
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Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
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General Anesthesia: Overview01:24

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Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
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Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
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Treatment strategies for poisoning are a critical aspect of emergency medicine, focusing on preventing the absorption of toxins and enhancing their elimination. When a poisoning incident occurs, the first response is to halt exposure and decontaminate the patient, particularly through gastrointestinal (GI) methods if the poison was ingested.Gastrointestinal Decontamination Techniques:Activated charcoal is the cornerstone of GI decontamination. It works through adsorption, binding the toxin to...
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Related Experiment Video

Updated: Mar 31, 2026

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
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High-Dose Continuous Propofol for Refractory Hyperactive Delirium: A Case Report.

Susana Marques-Martins1, Bruno Miguel-Freitas2, Fátima Domingues-Oliveira3

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Journal of Palliative Care
|March 30, 2026
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Summary

High-dose propofol infusion effectively managed refractory delirium in advanced cancer when standard treatments failed. This approach, used in palliative care, demonstrated safety and feasibility for prolonged symptom control.

Keywords:
antipsychotic agentsconscious sedationdeliriumhospice carehypnotics and sedativepalliative carepropofolterminally ill

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Area of Science:

  • Palliative Care
  • Oncology
  • Pharmacology

Background:

  • Delirium is a common, distressing symptom in advanced cancer, often resistant to typical treatments.
  • Palliative sedation may be necessary for uncontrolled symptoms, with propofol emerging as a potential option.

Purpose of the Study:

  • To describe the use of high-dose propofol infusion for pharmacoresistant delirium in advanced cancer.
  • To evaluate the safety and feasibility of long-term propofol infusion in a palliative care setting.

Main Methods:

  • A case report of a patient with Stage IV lung adenocarcinoma experiencing refractory hyperactive delirium.
  • Initiation of proportional palliative sedation using continuous intravenous propofol infusion, titrated to high doses.
  • Concurrent analgesia with transdermal fentanyl and monitoring of sedation depth.

Main Results:

  • Propofol infusion achieved adequate sedation within 10 minutes and was maintained for 25 days until the patient's death.
  • No respiratory or hemodynamic compromise, adverse effects, or signs of propofol infusion syndrome were observed.
  • Doses exceeded conventional thresholds, highlighting potential for refractory cases.

Conclusions:

  • High-dose, long-term propofol infusion is a feasible and safe rescue option for refractory delirium in advanced cancer.
  • Ethical considerations, rigorous monitoring, and family involvement are crucial for its use.
  • Propofol can be a valuable tool when standard palliative care regimens are insufficient.