CNS Drugs

, Volume 17, Issue 4, pp 235–272 | Cite as


A Review of its Use in Intensive Care Sedation of Adults
  • Kate McKeageEmail author
  • Caroline M. Perry
Adis Drug Evaluation



Propofol (Diprivan®1) is a phenolic derivative with sedative and hypnotic properties but is unrelated to other sedative/hypnotic agents. Formulated as an oil-in-water emulsion for intravenous use, it is highly lipophilic and rapidly crosses the blood-brain barrier resulting in a rapid onset of action. Emergence from sedation is also rapid because of a fast redistribution into peripheral tissues and metabolic clearance. The depth of sedation increases in a dose-dependent manner.

In well designed clinical trials in patients receiving sedation in the intensive care unit (ICU) for a variety of indications, propofol provided adequate sedation for a similar proportion of time to midazolam, but the rate of recovery was faster with propofol. Even after periods of prolonged sedation (>72 hours), propofol was generally associated with a faster time to recovery than midazolam. Propofol facilitated better predictability of recovery and an improved control of the depth of sedation in response to titration than midazolam. In patients sedated following head trauma, propofol reduced or maintained intracranial pressure.

Propofol is associated with generally good haemodynamic stability but induces a dose-dependent decrease in blood pressure and heart rate. Bolus administration may cause transient hypotension, and slow initial infusions are recommended in most patients. Serum triglyceride concentrations should be monitored during prolonged infusions (>3 days) because of the risk of hypertriglyceridaemia. The administration of 2% propofol can reduce this risk. Strict aseptic technique must be used during the handling of the product to prevent accidental extrinsic microbial contamination.

Despite a higher acquisition cost with propofol, most studies of short-term sedation (approximately <3 days) showed that overall costs were lower with propofol than with midazolam, because a faster time to extubation reduced total ICU costs. However, as the period of sedation increased, the cost difference decreased.

Conclusion: The efficacy of propofol in the sedation of adults in the ICU is well established, and clinical trials have demonstrated a similar quality of sedation to midazolam. Because of a rapid distribution and clearance, the duration of action of propofol is short and recovery is rapid. Emergence from sedation is more rapid with propofol than with midazolam, even after long-term administration (>72 hours), which enables better control of the depth of sedation in response to titration and more predictable recovery times. Thus, for the ICU sedation of adults in a variety of clinical settings, propofol provides effective sedation with a more rapid and predictable emergence time than midazolam.

Pharmacodynamic Properties

Continuous infusions of propofol (Diprivan®) increase the depth of sedation in a dose-dependent manner. A good correlation generally exists between plasma propofol concentrations and the depth of sedation. The target plasma propofol concentrations identified to achieve a Ramsay sedation score of 2–5 ranged from 0.25 to 2.0 mg/L.

A rapid metabolic clearance and redistribution into peripheral tissues result in faster emergence from sedation than midazolam, even after prolonged periods of sedation (≥7 days). The emergence from propofol sedation is dependent on the depth of sedation, the duration of sedation and the size of the patient.

Propofol causes a dose-dependent decrease in blood pressure as well as a less marked decrease in heart rate. Hypotension is greater with propofol than midazolam during administration of a bolus dose, but similar to midazolam during continuous infusions. The mean heart rate associated with propofol sedation is generally lower than that associated with midazolam. Propofol decreases total oxygen consumption to a similar extent to midazolam. Right ventricular ejection fraction was improved in patients with acute respiratory failure sedated with propofol. Propofol sedation is associated with slight respiratory depression.

Following head injury, sedation with propofol maintained or decreased intracranial pressure and, in most cases, mean cerebral perfusion pressure was maintained above the target value of 60mm Hg.

Long-term infusions of propofol (>7 days) may cause increases in serum triglyceride concentrations. When prolonged sedation is indicated, 2% propofol provides the advantage of less lipid administration and, therefore, less hypertriglyceridaemia.

Propofol containing the bacteriostatic agent disodium edetate (ethylene-diaminetetraacetic acid [EDTA]) did not alter calcium and magnesium homeostasis or renal function in critically ill patients in a variety of medical and surgical intensive care unit (ICU) settings.

Pharmacokinetic Properties

Propofol is highly lipophilic facilitating rapid penetration of the blood-brain barrier and a fast onset of action (usually within 40 seconds). The pharmacokinetic properties are characterised by a three-compartmental model: rapid initial distribution from blood into tissues, rapid redistribution and metabolic clearance, and a slow return from poorly perfused tissues into the bloodstream. The rapid redistribution into peripheral tissues (muscles and fat) and the rapid metabolic clearance result in a short duration of action (approximate half-life 30–60 minutes) and a fast emergence from sedation when the infusion is stopped (usually within 10–15 minutes).

Propofol has a linear pharmacokinetic profile. At steady state, the clearance of propofol is dependent on metabolism and distribution to peripheral tissues. The volume of distribution is large and increases as the duration of the infusion increases, but once peripheral compartments become saturated, the distributional component of clearance decreases. In obese patients, a greater accumulation in the fatty tissues can cause slower clearance. The total body clearance of propofol ranges from approximately 96 to 204 L/h (23–50 mL/kg/min) and exceeds hepatic blood flow, indicating some form of extrahepatic metabolism. Propofol is extensively metabolised and excreted in the urine (≥88%), mainly as inactive metabolites.

In elderly patients, the volume of distribution and clearance of propofol is decreased and a lower dosage is required. In patients with renal and hepatic impairment, propofol anaesthesia did not significantly affect the pharmacokinetic parameters compared with patients with normal hepatic and renal function, but the effects of long-term sedation have not been evaluated in this patient group.

Clinical Efficacy

In well designed clinical trials in adult patients requiring ICU sedation in various clinical settings (including following cardiac surgery), propofol provided a similar quality of sedation to midazolam but was associated with a faster rate of recovery.

In patients sedated for general medical conditions, trauma or following general surgery, propofol provided a similar quality of sedation to midazolam, lorazepam, dexmedetomidine and isoflurane. Propofol infusions administered for varying periods at mean infusion rates of 1.62–2.8 mg/kg/h provided adequate sedation for 62–97% of the time compared with 57–93% of the time with midazolam (0.04–0.2 mg/kg/h). In studies of patients receiving short- (≤24 hours), medium- (24–72 hours) or long-term (>72 hours) sedation, patients treated with propofol generally awoke more rapidly and with less variability than those treated with midazolam. For example, in a study of critically ill patients sedated for approximately 80 hours, those treated with propofol had a mean time to recovery of 23 minutes versus 137 minutes in the midazolam group (p < 0.05). Even after receiving sedative infusions for >7 days, propofol was associated with a faster time to recovery than midazolam. The control of the depth of sedation was easier with propofol than with midazolam, since patients receiving propofol responded more quickly to changes in the infusion rate.

After undergoing cardiac surgery, propofol provided patients with a similar or improved quality of sedation to midazolam. Compared with midazolam, propofol was associated with a faster mean time to spontaneous ventilation (66–197.8 vs 13.6–52 minutes, respectively) and, overall, a faster mean time to extubation.

Propofol provides good control of cerebral haemodynamics in patients sedated following head trauma or neurosurgery. In patients with head injuries, propofol controlled intracranial pressure as effectively as fentanyl or pentobarbital plus morphine and appeared more effective than midazolam plus morphine.


Propofol has a cardiovascular depressant effect, which can lead to hypotension (incidence of 26%) and a reduced heart rate. In particular, bolus doses of propofol are associated with marked transient hypotension. Care should be taken in the elderly and in patients who are haemodynamically unstable or hypovolaemic.

The lipid emulsion of the propofol formulation provides an excellent medium for the growth of a variety of organisms. To prevent accidental extrinsic microbial contamination, strict aseptic technique must be used during handling of both the original formulation and that containing the bacteriostatic agent EDTA.

Pain on injection is common with propofol when administered into peripheral veins, but it can be reduced by using the larger veins in the forearm. Hypertriglyceridaemia is associated with propofol infusions of >3 days. Other adverse effects associated with propofol include respiratory acidosis during weaning from the ventilator (3–10%), green discolouration of the urine and the rare occurrence of anaphylactoid reactions. Case reports have suggested the risk of a possible propofol-infusion syndrome leading to myocardial failure and death in some patients receiving long-term (>58 hours), high-dose (>5 mg/kg/h) infusions.

Pharmacoeconomic Considerations

Despite the higher acquisition cost of propofol, pharmacoeconomic studies have generally shown a cost advantage for propofol compared with midazolam, due to faster recovery times leading to reduced total ICU costs.

In patients requiring sedation for at least 12 hours, the total cost per patient for a stay in ICU was about two-thirds less for patients treated with propofol plus alfentanil compared with patients treated with midazolam plus morphine (£3 095 vs £9 511; p = 0.0013). In a study of patients receiving long-term sedation (≈5.5 days) with propofol (1–6 mg/kg/h) or midazolam (0.1–0.5 mg/kg/h), a total ICU cost difference of $US1 362 per patient was found in favour of propofol. Costs included drug costs ($US0.026/mg for propofol and $US0.123/mg for midazolam) and costs incurred during sedation and weaning periods.

A sensitivity analysis based on a hypothetical model developed from a well designed study of patients sedated for periods of approximately 16 hours predicted a potential saving with propofol of between $Can244 and $Can570 (1997 dollars) for each ICU patient compared with midazolam. This saving was due to the shorter time to extubation leading to improved discharge planning. Extubation time with propofol appeared to be 4.2 times faster, and drug costs 3.6 times higher, than with midazolam.

Overall, studies have shown that the cost differential between propofol and midazolam reduces as the period of sedation increases. During short-term sedation (<24 hours in one study and <72 hours in another) propofol had a significant cost advantage over midazolam, but for longer periods of sedation (>72 hours), the higher acquisition cost of propofol offset the savings made from the reduced time in ICU.

Dosage and Administration

Propofol intravenous injectable infusions should be initiated slowly at a dosage of 0.3 mg/kg/h and adjusted upwards, as clinically indicated, in increments of 0.3–0.6 mg/kg/h at intervals of at least 5 minutes. A rate of between 0.3 and 3.0 mg/kg/h should achieve satisfactory sedation in most patients. Elderly patients (>55 years) require a reduced rate of infusion (1.8 mg/kg/h).

There is large interpatient variability in dosage requirements, which may change over time. Titration of the propofol dosage should be made to clinical response, and daily assessment of sedation levels and CNS function are important to determine the minimum dosage required. Bolus doses of 1% propofol may be given if clinically indicated and if hypotension is not likely to occur. A light level of sedation is recommended during the weaning process with discontinuation of the infusion 10–15 minutes before extubation.


Intensive Care Unit Midazolam Mean Arterial Pressure Dexmedetomidine Cerebral Perfusion Pressure 
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  1. 1.
    Fulton B, Sorkin EM. Propofol.: an overview of its pharmacology and a review of its clinical efficacy in intensive care sedation. Drugs 1995 Oct; 50(4): 636–57PubMedCrossRefGoogle Scholar
  2. 2.
    Thompson KA, Goodale DB. The recent development of propofol (DIPRIVAN). Intensive Care Med 2000; 26(Suppl. 4): S400–4PubMedCrossRefGoogle Scholar
  3. 3.
    Diprivan 1% for I.V. administration: professional information brochure. Wilmington (DE): AstraZeneca, 2001Google Scholar
  4. 4.
    Mirenda J, Broyles G. Propofol as used for sedation in ICU. Chest 1995 Aug; 108: 539–48PubMedCrossRefGoogle Scholar
  5. 5.
    Whitehead C, Sanders LD, Oldroyd G, et al. The subjective effects of low-dose propofol: a double-blind study to evaluate dimensions of sedation and consciousness with low-dose propofol. Anaesthesia 1994; 49: 490–6PubMedCrossRefGoogle Scholar
  6. 6.
    Karski JM, Teasdale SJ, Boylan J, et al. Propofol for continuous intravenous sedation after aortocoronary bypass graft surgery: dose finding study [abstract]. Can J Anaesth 1994; 41(5 Suppl.): A17Google Scholar
  7. 7.
    O’Connor M, Stow P, Mortimer A, et al. Propofol to provide sedation after coronary artery bypass surgery: a comparison of two fixed rate infusion regimens. Acta Anaesthesiol Belg 1992; 43: 235–41PubMedGoogle Scholar
  8. 8.
    Aitkenhead AR, Willatts SM, Park GR, et al. Comparison of propofol and midazolam for sedation in critically ill patients. Lancet 1989 Sep 23; 2(8665): 704–9PubMedCrossRefGoogle Scholar
  9. 9.
    Barrientos-Vega R, Mar Sanchez-Soria M, Morales-Garcia C, et al. Prolonged sedation of critically ill patients with midazolam or propofol: impact on weaning and costs. Crit Care Med 1997 Jan; 25(1): 33–40PubMedCrossRefGoogle Scholar
  10. 10.
    Beyer R, Seyde WC. Propofol versus midazolam: long-term sedation in the intensive care unit [in German]. Anaesthesist 1992 Jun; 41(6): 335–41PubMedGoogle Scholar
  11. 11.
    Boyd O, Mackay CJ, Rushmer F, et al. Propofol or midazolam for short-term alterations in sedation. Can J Anaesth 1993 Dec; 40(12): 1142–7PubMedCrossRefGoogle Scholar
  12. 12.
    Chamorro C, de Latorre FJ, Montero A, et al. Comparative study of propofol versus midazolam in the sedation of critically ill patients: results of a prospective, randomized, multicenter trial. Crit Care Med 1996; 24(6): 932–9PubMedCrossRefGoogle Scholar
  13. 13.
    Früh B. A comparison of propofol and midazolam for long-term sedation of ventilated patients: a cross-over study. J Drug Dev 1989; 2Suppl. 2: 45–7Google Scholar
  14. 14.
    Weinbroum AA, Halpern P, Rudick V, et al. Midazolam versus propofol for long-term sedation in the ICU: a randomized prospective comparison. Intensive Care Med 1997 Dec; 23(12): 1258–63PubMedCrossRefGoogle Scholar
  15. 15.
    Wolfs C, Kimbimbi P, Colin L, et al. A comparison of propofol/ fentanyl and midazolam/fentanyl for ICU sedation after abdominal surgery. J Drug Dev 1991 Oct; 4 Suppl. 3: 69–71Google Scholar
  16. 16.
    Grounds RM, Lalor JM, Lumley J, et al. Propofol infusion for sedation in the intensive care unit: preliminary report. BMJ 1987 Feb 14; 294: 397–400PubMedCrossRefGoogle Scholar
  17. 17.
    Roekaerts PM, Huygen FJ, de Lange S. Infusion of propofol versus midazolam for sedation in the intensive care unit following coronary artery surgery. J Cardiothorac Vasc Anesth 1993 Apr; 7(2): 142–7PubMedCrossRefGoogle Scholar
  18. 18.
    Snellen F, Lauwers P, Demeyere R, et al. The use of midazolam versus propofol for short-term sedation following coronary artery bypass grafting. Intensive Care Med 1990; 16(5): 312–6PubMedCrossRefGoogle Scholar
  19. 19.
    Carrasco G, Cabré L, Sobrepere G, et al. Synergistic sedation with propofol and midazolam in intensive care patients after coronary artery bypass grafting. Crit Care Med 1998 May; 26(5): 844–51PubMedCrossRefGoogle Scholar
  20. 20.
    McMurray TJ, Collier PS, Carson IW, et al. Propofol sedation after open heart surgery: a clinical and pharmacokinetic study. Anaesthesia 1990 Apr; 45(4): 322–6PubMedCrossRefGoogle Scholar
  21. 21.
    Barr J, Egan TD, Sandoval NF, et al. Propofol dosing regimens for ICU sedation based upon an integrated pharmacokinetic-pharmacodynamic model. Anesthesiology 2001 Aug; 95(2): 324–33PubMedCrossRefGoogle Scholar
  22. 22.
    McMurray TJ, Johnston JR, Milligan KR, et al. Diprifusor TCI for sedation of ventilated adult ICU patients: target blood propofol concentration settings [poster]. Presented at the 22nd International Symposium of Intensive Care and Emergency Medicine; 2002 Mar 19–22; BrusselsGoogle Scholar
  23. 23.
    Newman LH, McDonald JC, Wallace PGM, et al. Propofol infusion for sedation in the intensive care unit [letter]. BMJ 1987; 294: 970–1CrossRefGoogle Scholar
  24. 24.
    Higgins TL, Yared J-P, Estafanous FG, et al. Propofol versus midazolam for intensive care unit sedation after coronary artery bypass grafting. Crit Care Med 1994 Sep; 22(9): 1415–23PubMedCrossRefGoogle Scholar
  25. 25.
    Ronan KP, Gallagher TJ, George B, et al. Comparison of propofol and midazolam for sedation in intensive care unit patients. Crit Care Med 1995 Feb; 23(2): 286–93PubMedCrossRefGoogle Scholar
  26. 26.
    Milne SE, James KS, Nimmo S, et al. Oxygen consumption after hypothermic cardiopulmonary bypass: the effect of continuing a propofol infusion postoperatively. J Cardiothorac Vasc Anesth 2002; 16(1): 32–6PubMedCrossRefGoogle Scholar
  27. 27.
    Kress JP, O’Connor MF, Pohlman AS, et al. Sedation of critically ill patients during mechanical ventilation: a comparison of propofol and midazolam. Am J Respir Crit Care Med 1996 Mar; 153: 1012–8PubMedGoogle Scholar
  28. 28.
    Langley MS, Heel RC. Propofol: a review of its pharmacodynamic and pharmacokinetic properties and use as an intravenous anaesthetic. Drugs 1988; 35: 334–72PubMedCrossRefGoogle Scholar
  29. 29.
    Pedersen CM. The effect of sedation with propofol on postoperative bronchoconstriction in patients with hyperreactive airway disease. Intensive Care Med 1992 Mar; 18: 45–6PubMedCrossRefGoogle Scholar
  30. 30.
    Conti G, Ferretti A, Tellan G, et al. Propofol induces bronchodilation in a patient mechanically ventilated for status asthmaticus [letter]. Intensive Care Med 1993 Jul; 19: 305PubMedCrossRefGoogle Scholar
  31. 31.
    Conti G, Dell’Utri D, Vilardi V, et al. Propofol induces bronchodilation in mechanically ventilated chronic obstructive pulmonary disease (COPD) patients. Acta Anaesthesiol Scand 1993; 37: 105–9PubMedCrossRefGoogle Scholar
  32. 32.
    Farling PA, Johnston JR, Coppel DL. Propofol infusion for sedation of patients with head injury in intensive care: a preliminary report. Anaesthesia 1989 Mar; 44(3): 222–6PubMedCrossRefGoogle Scholar
  33. 33.
    Farling PA, Johnston JR, Coppel DL. Propofol infusion compared with morphine and midazolam bolus doses for sedation of patients with severe head injuries in the intensive care unit. J Drug Dev 1989; 2 Suppl. 2: 97–8Google Scholar
  34. 34.
    Vezzani A, Barbagallo M, Furlan A, et al. Neurological assessment and ICP control in severe head injury: use of propofol as a short-acting sedative agent. J Drug Dev 1991; 4 Suppl. 3: 114–5Google Scholar
  35. 35.
    Mergaert C, Herregods L, Rolly G, et al. The effect of a 24-h propofol or fentanyl sedation on intracranial pressure [abstract]. Eur J Anaesthesiol 1991; 8: 324–5Google Scholar
  36. 36.
    Weinstabl C, Mayer N, Plattner H, et al. Impact of propofol on intracranial dynamics in head trauma ICU patients [abstract no. A1217]. Anesthesiology 1990 Sep; 73 (Suppl. 3A)Google Scholar
  37. 37.
    Boyle WA, Shear JM, White PF, et al. Long-term sedative infusion in the intensive care unit: propofol versus midazolam. J Drug Dev 1991 Oct; 4Suppl. 3: 43–5Google Scholar
  38. 38.
    Foster SJ, Buckley PM. A retrospective review of two years’ experience with propofol in one intensive care unit. J Drug Dev 1989; 2 Suppl. 2: 73–4Google Scholar
  39. 39.
    Buckley PM. Propofol in patients needing long-term sedation in intensive care: an assessment of the development of tolerance. A pilot study. Intensive Care Med 1997 Sep; 23(9): 969–74CrossRefGoogle Scholar
  40. 40.
    Cook S, Palma O. Propofol as a sole agent for prolonged infusion in intensive care. J Drug Dev 1989; 2 Suppl. 2: 65–7Google Scholar
  41. 41.
    Carrasco G, Molina R, Costa J, et al. Propofol vs midazolam in short-, medium-, and long-term sedation of critically ill patients; a cost-benefit analysis. Chest 1993; 103(2): 557–64PubMedCrossRefGoogle Scholar
  42. 42.
    McLeod G, Dick J, Wallis C, et al. Propofol 2% in critically ill patients: effect on lipids. Crit Care Med 1997 Dec; 25(12): 1976–81PubMedCrossRefGoogle Scholar
  43. 43.
    Barrientos-Vega R, Sánchez-Soria MM, Morales-Garcia C, et al. Pharmacoeconomic assessment of propofol 2% used for prolonged sedation. Crit Care Med 2001 Feb; 29(2): 317–22PubMedCrossRefGoogle Scholar
  44. 44.
    Plunkett JJ, Reeves JD, Ngo L, et al. Urine and plasma catecholamine and cortisol concentrations after myocardial revascularization: modulation by continuous sedation. Anesthesiology 1997 Apr; 86(4): 785–96PubMedCrossRefGoogle Scholar
  45. 45.
    Heller A, Heller S, Blecken S, et al. Effects of intravenous anesthetics on bacterial elimination in human blood in vitro. Acta Anaesthesiol Scand 1998; 42: 518–26PubMedCrossRefGoogle Scholar
  46. 46.
    Mikawa K, Akamatsu H, Nishina K, et al. Propofol inhibits human neutrophil functions. Anesth Analg 1998; 87: 695–700PubMedGoogle Scholar
  47. 47.
    Galley HF, Dubbels AM, Webster NR. The effect of midazolam and propofol on interleukin-8 from human polymorphonuclear leukocytes. Anesth Analg 1998; 86: 1289–93PubMedGoogle Scholar
  48. 48.
    Pirttikangas C-O, Perttilä J, Salo M. Propofol emulsion reduces proliferative responses of lymphocytes from intensive care patients. Intensive Care Med 1993 Jul; 19: 299–302PubMedCrossRefGoogle Scholar
  49. 49.
    Kelbel I, Weiss M. Anaesthetics and immune function. Curr Opin Anaesthesiol 2001; 14(6): 685–91PubMedCrossRefGoogle Scholar
  50. 50.
    Barr J, Egan T, Feeley T, et al. Depth of sedation vs. propofol concentration in mechanically ventilated ICU patients [abstract no. A313]. Anesthesiology 1992 Sep; 77 Suppl. 3AGoogle Scholar
  51. 51.
    Sorbara C, Armellin G, Bonato A, et al. Postoperative sedation with propofol infusion: haemodynamics and pharmacokinetics. Clin Drug Invest 1998; 16(6): 431–9CrossRefGoogle Scholar
  52. 52.
    Wang S-H, Hsu K-Y, Uang Y-S. Long-term continuous infusion of propofol as a means of sedation for patients in intensive care unit: relationship between dosage and serum concentration. Acta Anaesthesiol Sin 1998 Jun; 36(2): 93–8PubMedGoogle Scholar
  53. 53.
    Ramsay MAE, Savege TM, Simpson BRJ, et al. Controlled sedation with alphaxalone-alphadolone. BMJ 1974; 2: 656–9PubMedCrossRefGoogle Scholar
  54. 54.
    Angelini G, Ketzler JT, Coursin DB. Use of propofol and other nonbenzodiazepine sedatives in the intensive care unit. Crit Care Clin 2001 Oct; 17(4): 863–80PubMedCrossRefGoogle Scholar
  55. 55.
    Telci I, Denkel T, Esen F, et al. Cardiocirculatory effects of propofol in acute respiratory failure: a clinical trial. J Drug Dev 1991 Oct; 4 Suppl. 3: 93–4Google Scholar
  56. 56.
    Searle NR, Côté S, Taillefer J, et al. Propofol or midazolam for sedation and early extubation following cardiac surgery. Can J Anaesth 1997 Jun; 44(6): 629–35PubMedCrossRefGoogle Scholar
  57. 57.
    Venn RM, Grounds RM. Comparison between dexmedetomidine and propofol for sedation in the intensive care unit: patient and clinician perceptions. Br J Anaesth 2001 Nov; 87(5): 684–90PubMedCrossRefGoogle Scholar
  58. 58.
    Sandiumenge Camps A, Sanchez-Izquierdo Riera JA, Toral Vazquez D, et al. Midazolam and 2% propofol in long-term sedation of traumatized critically ill patients: efficacy and safety comparison. Crit Care Med 2000 Nov; 28(11): 3612–9PubMedCrossRefGoogle Scholar
  59. 59.
    Ewart MC, Yau KW, Morgan M. 2% Propofol for sedation in the intensive care unit: a feasibility study. Anaesthesia 1992 Feb; 47(2): 146–8PubMedCrossRefGoogle Scholar
  60. 60.
    Hammarén E, Scheinin M, Hynynen M. Effect of low-dose propofol infusion on total-body oxygen consumption after coronary artery surgery. J Cardiothorac Vasc Anesth 1999 Apr; 13(2): 154–9PubMedCrossRefGoogle Scholar
  61. 61.
    Cohen D, Horiuchi K, Kemper M, et al. Modulating effects of propofol on metabolic and cardiopulmonary responses to stressful intensive care unit procedures. Crit Care Med 1996; 24(4): 612–7PubMedCrossRefGoogle Scholar
  62. 62.
    McMurray TC. Propofol for sedation following cardiac surgery. J Drug Dev 1991; 4 Suppl. 3: 51–8Google Scholar
  63. 63.
    Barr J. Propofol: a new drug for sedation in the intensive care unit. Int Anesthesiol Clin 1995 Winter; 33(1): 131–54PubMedCrossRefGoogle Scholar
  64. 64.
    Hall RI, Sandham D, Cardinal P, et al. Propofol vs midazolam for ICU sedation: a Canadian multicenter randomized trial. Chest 2001 Apr; 119(4): 1151–9PubMedCrossRefGoogle Scholar
  65. 65.
    Khamiees M, Amoateng-Adjepong Y, Manthous CA. Propofol infusion is associated with a higher rapid shallow breathing index in patients preparing to wean from mechanical ventilation. Respir Care 2002 Feb; 47(2): 150–3PubMedGoogle Scholar
  66. 66.
    Shafer A. Complications of sedation with midazolam in the intensive care unit and a comparison with other sedative regimens. Crit Care Med 1998 May; 26(5): 947–56PubMedCrossRefGoogle Scholar
  67. 67.
    Degaugue C, Dupuis A. A study to compare the use of propofol and midazolam for the sedation of patients with acute respiratory failure. J Drug Dev 1991 Oct; 4 Suppl. 3: 95–7Google Scholar
  68. 68.
    Stewart L, Bullock R, Rafferty C, et al. Propofol sedation in severe head injury fails to control high ICP, but reduces brain metabolism. Acta Neurochir 1994; 60 Suppl.: 544–6Google Scholar
  69. 69.
    Matta BF, Risdall J, Menon DK, et al. The effect of propofol on cerebral autoregulation after head injury: a preliminary report. Br J Anaesth 1997 May; 78 Suppl. 1: 72Google Scholar
  70. 70.
    Kishimoto T, Kadoya C, Sneyd R, et al. Topographic electroencephalogram of propofol-induced conscious sedation. Clin Pharmacol Ther 1995; 58: 666–74PubMedCrossRefGoogle Scholar
  71. 71.
    Theilen HJ, Adam S, Kuhlisch E, et al. Progressive electroencephalogram frequency deceleration despite constant depth of propofol-induced sedation. Crit Care Med 2002 Aug; 30(8): 1787–93PubMedCrossRefGoogle Scholar
  72. 72.
    Sneyd JR, Samra SK, Davidson B, et al. Electrophysiologic effects of propofol sedation. Anesth Analg 1994; 79: 1151–8PubMedCrossRefGoogle Scholar
  73. 73.
    Magarey JM. Propofol or midazolam — which is best for the sedation of adult ventilated patients in intensive care units? A systematic review. Aust Crit Care 2001 Nov; 14(4): 147–54PubMedCrossRefGoogle Scholar
  74. 74.
    Treggiari-Venzi M, Borgeat A, Fuchs-Buder T, et al. Overnight sedation with midazolam or propofol in the ICU: effects on sleep quality, anxiety and depression. Intensive Care Med 1996 Nov; 22(11): 1186–90PubMedCrossRefGoogle Scholar
  75. 75.
    McLeod G, Wallis C, Dick J, et al. Use of 2% propofol to produce diurnal sedation in critically ill patients. Intensive Care Med 1997 Apr; 23(4): 428–34PubMedCrossRefGoogle Scholar
  76. 76.
    Polster MR, Gray PA, O’Sullivan G, et al. Comparison of the sedative and amnesic effects of midazolam and propofol. Br J Anaesth 1993; 70: 612–6PubMedCrossRefGoogle Scholar
  77. 77.
    Montanini S, Pratico C, Tufano R, et al. Propofol for sedation in the intensive care unit: comparative evaluation of 1% and 2% formulations. Br J Intensive Care 1999; 9(4): 110–4Google Scholar
  78. 78.
    Leisure GS, O’Flaherty J, Green L, et al. Propofol and postoperative pancreatitis. Anesthesiology 1996; 84(1): 224–7PubMedCrossRefGoogle Scholar
  79. 79.
    Kumar AN, Schwartz DE, Lim KG. Propofol-induced pancreatitis: recurrence of pancreatitis after rechallenge. Chest 1999; 115: 1198–9PubMedCrossRefGoogle Scholar
  80. 80.
    Possidente CJ, Rogers FB, Osler TM, et al. Elevated pancreatic enzymes after extended propofol therapy. Pharmacotherapy 1998; 18(3): 653–5PubMedGoogle Scholar
  81. 81.
    Wingfield TW. Pancreatitis after propofol administration: is there a relationship? Anesthesiology 1996; 84(1): 236PubMedCrossRefGoogle Scholar
  82. 82.
    Piper SN, Kumle B, Maleck WH, et al. Effects of postoperative sedation with propofol and midazolam on pancreatic function assessed by pancreatitis-associated protein. Anaesthesia 2001 Sep; 56(9): 836–40PubMedCrossRefGoogle Scholar
  83. 83.
    Hall RI, MacLaren C, Smith MS, et al. Light versus heavy sedation after cardiac surgery: myocardial ischemia and the stress response. Anesth Analg 1997 Nov; 85: 971–8PubMedGoogle Scholar
  84. 84.
    Cox C, McLeod G, Wallis C, et al. Use of 2% propofol to produce night sedation in critically ill patients: effect on hormones. Br J Anaesth 1995 May; 74 Suppl. 1: 114CrossRefGoogle Scholar
  85. 85.
    Lee T-L, Ang SBL, Dambisya YM, et al. The effect of propofol on human gastric and colonic muscle contractions. Anesth Analg 1999 Nov; 89(5): 1246–9PubMedCrossRefGoogle Scholar
  86. 86.
    Freye E, Sundermann S, Wilder-Smith OHG. No inhibition of gastro-intestinal propulsion after propofol- or propofol/ ketamine-N2O/O2 anaesthesia: a comparison of gastro-caecal transit after isoflurane anaesthesia. Acta Anaesthesiol Scand 1998 Jul; 42(6): 664–9PubMedCrossRefGoogle Scholar
  87. 87.
    Devlin EG, Clarke RSJ, Mirakhur RK, et al. Effect of four i.v. induction agents on T-lymphocyte proliferations to PHA in vitro. Br J Anaesth 1994; 73: 315–7Google Scholar
  88. 88.
    O’Donnell CA, O’Donnell NG, McSharry CP, et al. Comparison of the effects of propofol and thiopentone on white blood cell function. Hum Exp Toxicol 1991; 10(6): 483Google Scholar
  89. 89.
    Helmy SAK, Wahby MAM, El-Nawaway M. The effect of anaesthesia and surgery on plasma cytokine production. Anaesthesia 1999; 54(8): 733–8PubMedCrossRefGoogle Scholar
  90. 90.
    Helmy SAK, Al-Attiyah RJ. The immunomodulatory effects of prolonged intravenous infusion of propofol versus midazolam in critically ill surgical patients. Anaesthesia 2001; 56: 4–8PubMedCrossRefGoogle Scholar
  91. 91.
    Abraham E, Papadakos PJ, Tharratt RS, et al. Effects of propofol containing EDTA on mineral metabolism in medical ICU patients with pulmonary dysfunction. Intensive Care Med 2000; 26Suppl. 4: S422–32PubMedCrossRefGoogle Scholar
  92. 92.
    Herr DL, Kelly K, Hall JB, et al. Safety and efficacy of propofol with EDTA when used for sedation of surgical intensive care unit patients. Intensive Care Med 2000; 26Suppl. 4: S452–62PubMedCrossRefGoogle Scholar
  93. 93.
    Wahr J, Vender J, Gilbert HC, et al. Effect of propofol with and without EDTA on haemodynamics and calcium and magnesium homeostasis during and after cardiac surgery. Intensive Care Med 2000; 26 Suppl.: 443–51CrossRefGoogle Scholar
  94. 94.
    Higgins TL, Murray M, Kett DH, et al. Trace element homeostasis during continuous sedation with propofol containing EDTA versus other sedatives in critically ill patients. Intensive Care Med 2000; 26Suppl. 4: S413–21PubMedCrossRefGoogle Scholar
  95. 95.
    Zaloga GP, Youngs E, Teres D. Propofol-containing sedatives increase levels of parathyroid hormone. Intensive Care Med 2000; 26 Suppl.: 405–12CrossRefGoogle Scholar
  96. 96.
    Kanto J, Gepts E. Pharmacokinetic implications for the clinical use of propofol. Clin Pharmacokinet 1989; 17(5): 308–26PubMedCrossRefGoogle Scholar
  97. 97.
    Frenkel C, Schüttler J, Ihmsen H, et al. Pharmacokinetics and pharmacodynamics of propofol/alfentanil infusions for sedation in ICU patients. Intensive Care Med 1995 Dec; 21(12): 981–8PubMedCrossRefGoogle Scholar
  98. 98.
    Albanese J, Martin C, Lacarelle B, et al. Pharmacokinetics of long-term propofol infusion used for sedation in ICU patients. Anesthesiology 1990; 73(2): 214–7PubMedCrossRefGoogle Scholar
  99. 99.
    Bailie GR, Cockshott ID, Douglas EJ, et al. Pharmacokinetics of propofol during and after long-term continuous infusion for maintenance of sedation in ICU patients. Br J Anaesth 1992 May; 68(5): 486–91PubMedCrossRefGoogle Scholar
  100. 100.
    Cockshott ID. The pharmacokinetics of propofol in the ICU patient. J Drug Dev 1991 Oct; 4 Suppl. 3: 29–36Google Scholar
  101. 101.
    AstraZeneca. Diprivan global prescribing information [online]. Available from URL: [Accessed 2002 Nov 1]
  102. 102.
    Zamacona MK, Suárez E, Aguilera L, et al. Serum protein binding of propofol in critically ill patients. Acta Anaesthesiol Scand 1997 Nov; 41: 1267–72PubMedCrossRefGoogle Scholar
  103. 103.
    Simons PJ, Cockshott ID, Douglas EJ, et al. Disposition in male volunteers of a subanaesthetic intravenous dose of an oil in water emulsion of 14C-propofol. Xenobiotica 1988; 4: 429–40CrossRefGoogle Scholar
  104. 104.
    Van Brandt N, Hantson P, Horsmans Y, et al. Effect of enteral versus parenteral feeding on hepatic blood flow and steady state propofol pharmacokinetics in ICU patients. Intensive Care Med 1998 Aug; 24(8): 795–800PubMedCrossRefGoogle Scholar
  105. 105.
    Kirkpatrick T, Cockshott ID, Douglas EJ, et al. Pharmacokinetics of propofol (Diprivan) in elderly patients. Br J Anaesth 1988; 60: 146–50PubMedCrossRefGoogle Scholar
  106. 106.
    Shafer A, Doze VA, Shafer SL, et al. Pharmacokinetics and pharmacodynamics of propofol infusions during general anesthesia. Anesthesiology 1988; 69: 348–56PubMedCrossRefGoogle Scholar
  107. 107.
    Eddleston JM, Pollard BJ, Blades JF, et al. The use of propofol for sedation of critically ill patients undergoing haemodiafiltration. Intensive Care Med 1995 Apr; 21: 342–7PubMedCrossRefGoogle Scholar
  108. 108.
    Barr J, Zaloga GP, Haupt MT, et al. Cation metabolism during propofol sedation with and without EDTA in patients with impaired renal function. Intensive Care Med 2000; 26Suppl. 4: S433–42PubMedCrossRefGoogle Scholar
  109. 109.
    Ibrahim AE, Park S, Feldman J, et al. No effect of parecoxib, a parenteral COX-2 specific inhibitor, on the disposition of propofol. Anaesth Intensive Care 2002 Apr; 30: 247Google Scholar
  110. 110.
    McCollam JS, O’Neil MG, Norcross ED, et al. Continuous infusions of lorazepam, midazolam, and propofol for sedation of the critically ill surgery trauma patient: a prospective, randomized comparison. Crit Care Med 1999 Nov; 27(11): 2454–8PubMedCrossRefGoogle Scholar
  111. 111.
    Millane TA, Bennett ED, Grounds RM. Isoflurane and propofol for long-term sedation in the intensive care unit: a crossover study. Anaesthesia 1992 Sep; 47(9): 768–74PubMedCrossRefGoogle Scholar
  112. 112.
    O’Connor M, Stow P, Mortimer A, et al. Propofol to provide sedation after coronary artery by-pass surgery: a comparison of three fixed-rate infusion regimens. J Drug Dev 1989; 2 Suppl. 2: 135–7Google Scholar
  113. 113.
    Vandenberghe J, Rucquoi M, Camu F. Propofol sedation for controlled ventilation of post-operative aortic surgery patients: an evaluation of haemodynamics and sedation. J Drug Dev 1991; 4 Suppl. 3: 65–6Google Scholar
  114. 114.
    Beller JP, Pottecher T, Lugnier A, et al. Prolonged sedation with propofol in ICU patients: recovery and blood concentration changes during periodic interruptions in infusion. Br J Anaesth 1988; 61: 583–8PubMedCrossRefGoogle Scholar
  115. 115.
    d’Athis F, Chardon P, Mathieu-Daudé JC, et al. Propofol for sedation in the intensive care unit. J Drug Dev 1989; 2Suppl. 2: 61–4Google Scholar
  116. 116.
    DuGres B, Flamens C. A comparison of propofol and midazolam infusion for post operative sedation after cardiac surgery [abstract]. J Cardiothorac Anesth 1990; 4(6 Suppl. 3): 101CrossRefGoogle Scholar
  117. 117.
    Nollet G, Verbeke J. Comparison of propofol and alfentanil as sedative agents after coronary artery by-pass graft. J Drug Dev 1991; 4 Suppl. 3: 62–4Google Scholar
  118. 118.
    Leino K, Nunes S, Valta P, et al. The effect of sedation on weaning following coronary artery bypass grafting: propofol versus oxycodone-thiopental. Acta Anaesthesiol Scand 2000 Apr; 44(4): 369–77PubMedCrossRefGoogle Scholar
  119. 119.
    Wahr JA, Plunkett JJ, Ramsay JG, et al. Cardiovascular responses during sedation after coronary revascularization. Incidence of myocardial ischemia and hemodynamic episodes with propofol versus midazolam. Anesthesiology 1996; 84(6): 1350–60Google Scholar
  120. 120.
    Mirski MA, Muffelman B, Ulatowski JA, et al. Sedation for the critically ill neurologic patient. Crit Care Med 1995; 23(12): 2038–53PubMedCrossRefGoogle Scholar
  121. 121.
    Pearson K, Kruse G, Demetrion E. Sedation of patients with severe head injury. a randomized, prospective comparison of propofol versus morphine and barbiturates [abstract no. A248]. Anesthesiology 1991; 75 (3A)Google Scholar
  122. 122.
    Kelly DF, Goodale DB, Williams J, et al. Propofol in the treatment of moderate and severe head injury: a randomized, prospective double-blinded pilot trial. J Neurosurg 1999; 90: 1042–52PubMedCrossRefGoogle Scholar
  123. 123.
    Smith M. Postoperative neurosurgical care. Curr Anaesth Crit Care 1994; 5(1): 29–35CrossRefGoogle Scholar
  124. 124.
    Dewandre J, Van Bos RJ, Van Hemelrijck J, et al. Comparison of the 2% and 1% formulations of propofol during anaesthesia for craniotomy. Anaesthesia 1994; 49: 8–12PubMedCrossRefGoogle Scholar
  125. 125.
    Escarment J, Donne X, Palmier B, et al. Quality of sedation and neurologic evaluation following surgery of the posterior cranial fossa: the importance of propofol [in French]. Cah Anesthesiol 1992; 40(1): 29–35PubMedGoogle Scholar
  126. 126.
    Clarke TNS. Propofol compared with midazolam for sedation following prolonged neurosurgery. J Drug Dev 1991; 4 Suppl. 3: 108–9Google Scholar
  127. 127.
    Löffler WH, Wallner F, Fischer J, et al. Comparison of electroencephalography, cerebral perfusion pressure, and recovery times following propofol of methohexital sedation in neurosurgical patients. J Clin Monit 1993; 9(2): 146–7Google Scholar
  128. 128.
    MacKenzie SJ, Kapadia F, Grant IS. Propofol infusion for control of status epilepticus. Anaesthesia 1990; 45: 1043–5PubMedCrossRefGoogle Scholar
  129. 129.
    McBurney JW, Teiken PJ, Moon MR. Propofol for treating status epilepticus. J Epilepsy 1994; 7(1): 21–2CrossRefGoogle Scholar
  130. 130.
    Natalè E, Mattaliano A, Alia G, et al. Propofol in treatment of status epilepticus: report of four cases successfully treated [abstract]. Epilepsia 1993; 34 Suppl. 2: 124–5Google Scholar
  131. 131.
    Rousseff R, Bojinov St, Platikanov W. Propofol in intractable status epilepticus. Epilepsia 1996; 37 Suppl. 4: 74–5Google Scholar
  132. 132.
    Wood PR, Browne GPR, Pugh S. Propofol infusion for the treatment of status epilepticus [letter]. Lancet 1988 Feb; 1(8583): 480–1PubMedCrossRefGoogle Scholar
  133. 133.
    Yanny HF, Christmas D. Propofol infusions for status epilepticus [letter]. Anaesthesia 1988; 43(6): 514PubMedCrossRefGoogle Scholar
  134. 134.
    Saeed AB, Javidan M. Propofol for treatment of non convulsive status epilepticus in intensive care unit [abstract]. Crit Care Med 2000 Dec; 28 Suppl.: 98Google Scholar
  135. 135.
    Fox FL, Bostwick JM. Propofol sedation of refractory delirious mania. Psychosomatics 1997; 38(3): 288–90PubMedCrossRefGoogle Scholar
  136. 136.
    Ermakov S, Hoyt J, Crippen D. Conscious sedation with propofol in patients with delirium tremens [abstract]. Crit Care Med 1995; 23(1): A68CrossRefGoogle Scholar
  137. 137.
    Stiebel VG, Crippen D, Ermakov S. Treatment of delirium tremens with continuous propofol infusion [abstract]. Psychosomatics 1994; 35(2): 193Google Scholar
  138. 138.
    Borgeat A, Popovis V, Schwander D. Efficiency in a continuous infusion of propofol in a patient with tetanus. Crit Care Med 1991; 19(2): 295–7PubMedCrossRefGoogle Scholar
  139. 139.
    Borgeat A, Dessibourg C, Rochani M, et al. Sedation by propofol in tetanus — is it a muscular relaxant? Intensive Care Med 1991; 17: 427–9PubMedCrossRefGoogle Scholar
  140. 140.
    Orko R, Rosenberg PH, Himberg J-J. Intravenous infusion of midazolam, propofol and vecuronium in a patient with severe tetanus. Acta Anaesthesiol Scand 1988 Oct; 32(7): 590–2PubMedCrossRefGoogle Scholar
  141. 141.
    Parke TJ, Stevens JE, Rice ASC, et al. Metabolic acidosis and fatal myocardial failure after propofol infusion in children: five case reports. BMJ 1992; 305(6854): 613–6PubMedCrossRefGoogle Scholar
  142. 142.
    Bray RJ. Propofol infusion syndrome in children. Paediatr Anaesth 1998; 8: 491–9PubMedCrossRefGoogle Scholar
  143. 143.
    Kelly DF. Propofol-infusion syndrome. J Neurosurg 2001; 95: 925–6PubMedCrossRefGoogle Scholar
  144. 144.
    Cremer OL, Moons KGM, Bouman EAC, et al. Long-term propofol infusion and cardiac failure in adult head-injured patients [letter]. Lancet 2001 Jan 13; 357(9250): 117–8PubMedCrossRefGoogle Scholar
  145. 145.
    Perrier ND, Baerga-Varela Y, Murray MJ. Death related to propofol use in an adult patient. Crit Care Med 2000 Aug; 28(8): 3071–4PubMedCrossRefGoogle Scholar
  146. 146.
    Sutherland MJ, Burt P. Propofol and seizures. Anaesth Intensive Care 1994 Dec; 22: 733–7PubMedGoogle Scholar
  147. 147.
    Collier C, Kelly K. Propofol and convulsions: the evidence mounts. Anaesth Intensive Care 1991 Nov; 19: 573–5PubMedGoogle Scholar
  148. 148.
    McManus KF. Convulsion after propofol enflurane [letter]. Anaesth Intensive Care 1992 May; 20: 245PubMedGoogle Scholar
  149. 149.
    Harrigan PWJ, Browne SM, Quail AW. Multiple seizures following re-exposure to propofol. Anaesth Intensive Care 1996 Apr; 24: 261–4PubMedGoogle Scholar
  150. 150.
    Bennett SN, McNeil MM, Bland LA, et al. Postoperative infections traced to contamination of an intravenous anesthetic, propofol. N Engl J Med 1995; 333(3): 147–54PubMedCrossRefGoogle Scholar
  151. 151.
    Webb SAR, Roberts B, Breheny FX, et al. Contamination of propofol infusions in the intensive care unit: incidence and clinical significance. Anaesth Intensive Care 1998 Apr; 26(2): 162–4PubMedGoogle Scholar
  152. 152.
    Bach A, Motsch J, Schmidt H, et al. In-use contamination of propofol. A clinical study. Eur J Anaesthesiol 1997 Mar; 14: 178–83Google Scholar
  153. 153.
    Marinella MA. Propofol for sedation in the intensive care unit: essentials for the clinician. Respir Med 1997 Oct; 91(9): 505–10PubMedCrossRefGoogle Scholar
  154. 154.
    Bodenham A, Culank LS, Park GR. Propofol infusion and green urine [letter]. Lancet 1987; 11: 740CrossRefGoogle Scholar
  155. 155.
    Ananthanarayan C, Fisher JA. Why was the urine green? [letter]. Can J Anaesth 1995; 42(1): 87–8PubMedCrossRefGoogle Scholar
  156. 156.
    Motsch J, Schmidt H, Bach A, et al. Long-term sedation with propofol and green discolouration of the liver. Eur J Anaesthesiol 1994 Nov; 11(6): 499–502PubMedGoogle Scholar
  157. 157.
    Callander CC, Thomas JS, Evans CJ. Propofol and the colour green [letter]. Anaesthesia 1989; 44: 82PubMedCrossRefGoogle Scholar
  158. 158.
    McHale SP, Konieczko K. Anaphylactoid reaction to propofol. Anaesthesia 1992; 47: 864–5PubMedCrossRefGoogle Scholar
  159. 159.
    Laxenaire M-C, Mata-Bermejo E, Moneret-Vautrin DA, et al. Life-threatening anaphylactoid reactions to propofol (Diprivan). Anesthesiology 1992; 77: 275–80PubMedCrossRefGoogle Scholar
  160. 160.
    Anis AH, Wang X, Leon H, et al. Economic evaluation of propofol for sedation of patients admitted to intensive care units. Anesthesiology 2002 Jan; 96(1): 196–201PubMedCrossRefGoogle Scholar
  161. 161.
    Manley NM, Fitzpatrick RW, Long T, et al. A cost analysis of alfentanil+propofol vs morphine+midazolam for the sedation of critically ill patients. Pharmacoeconomics 1997 Aug; 12 (2 Pt 2): 247–55PubMedCrossRefGoogle Scholar
  162. 162.
    Sherry KM, McNamara J, Brown JS, et al. An economic evaluation of propofol/fentanyl compared with midazolam/ fentanyl on recovery in the ICU following cardiac surgery. Anaesthesia 1996 Apr; 51: 312–7PubMedCrossRefGoogle Scholar
  163. 163.
    Costa J, Cabré L, Molina R, et al. Cost of ICU sedation: comparison of empirical and controlled sedation methods. Clin Intensive Care 1994; 5(5 Suppl.): 17–21PubMedGoogle Scholar
  164. 164.
    Cheng DCH, Karski J, Peniston C, et al. Early tracheal extubation after coronary artery bypass graft surgery reduces costs and improves resource use: a prospective randomized controlled trial. Anesthesiology 1996; 85: 1300–10PubMedCrossRefGoogle Scholar
  165. 165.
    Jacobi J, Fraser GL, Coursin DB, et al. Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Crit Care Med 2002; 30(1): 119–40PubMedCrossRefGoogle Scholar
  166. 166.
    Kang TM. Propofol infusion syndrome in critically ill patients. Ann Pharmacother 2002; 36: 1453–6PubMedCrossRefGoogle Scholar
  167. 167.
    Abraham E. Managing sedative agents in common ICU settings. Crit Care Med 2002; 30(1 Suppl. A): S110–3Google Scholar
  168. 168.
    Young C, Knudsen N, Hilton A, et al. Sedation in the intensive care unit. Crit Care Med 2000 Mar; 28(3): 854–66PubMedCrossRefGoogle Scholar
  169. 169.
    Hill L, Bertaccini E, Barr J, et al. ICU sedation: a review of its pharmacology and assessment. J Intensive Care Med 1998; 13(4): 174–83CrossRefGoogle Scholar
  170. 170.
    Radu O, Groth M. Propofol or midazolam for sedation in the ICU: which one is better? Clin Pulmonary Med 2001; 8(5): 303–4CrossRefGoogle Scholar
  171. 171.
    Shapiro BA, Warren J, Egol AB, et al. Practice parameters for intravenous analgesia and sedation for adult patients in the intensive care unit: an executive summary. Crit Care Med 1995 Sep; 23(9): 1596–600PubMedCrossRefGoogle Scholar
  172. 172.
    Meade MO, Guyatt G, Butler R, et al. Trials comparing early vs late extubation following cardiovascular surgery. Chest 2001 Dec; 120(6 Suppl.): 445S–53SPubMedCrossRefGoogle Scholar
  173. 173.
    Crippen D. High-tech assessment of patient comfort in the intensive care unit: time for a new look. Crit Care Med 2002 Aug; 30(8): 1919–20PubMedCrossRefGoogle Scholar
  174. 174.
    Baxter Healthcare Corporation. Propofol: injectable emulsion 1% 10 mg/ml propofol. Prescribing information. Irvine (CA): Baxter Healthcare Corporation, 2002 JulGoogle Scholar

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  1. 1.Adis International LimitedMairangi Bay, Auckland 10New Zealand

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