Paweł Radkowski, Bartosz Kędziora, Adrian Borkowski, Aleksandra Kłosińska, Julia Młyńska

Propofol as a double-edged sword
2024-07-25

Background. Propofol is the most commonly used intravenous hypnotic drug in anesthesiology and intensive care practice. Its characteristic appearance is due to stabilizers such as lecithin, soybean oil, and glycerol. Propofol undergoes biotransformation primarily in the liver, with renal clearance facilitating drug elimination. The pharmacokinetics of propofol depend on factors such as the patient’s body mass, comorbidities, sex, age, and concomitant medications.

Aim of the study. The aim of this study is to gather and systematize knowledge on propofol, highlighting its advantages and potential risks, and to discuss the latest advancements and innovative research directions concerning this drug.

Materials and methods. A literature review was conducted using the PubMed and Google Scholar databases. Relevant articles on propofol were identified through a combination of keywords: “propofol”, “anesthesia”, “anesthesiology”, “intensive care”, “propofol infusion syndrome”, “adverse effects”, “drug interactions”, “pregnancy”, and “cancer”.

Results. The broader discussion on propofol encompasses its characteristic properties and lesser-known aspects, such as antiemetic and anticonvulsant effects. However, there are limitations and potential risks associated with its use, including the risk of propofol infusion syndrome. Additionally, considerations such as lipid balance and the risk of bacterial growth in drug ampoules must be addressed. The latest research indicates potential benefits of propofol in other medical fields, such as its impact on limiting the growth of gastric cancer cells, bladder cancer, and osteosarcoma.

Conclusions. This study focuses on medications primarily used by specialists in anesthesiology and intensive care. However, physicians from other specialties and pharmacists may encounter propofol in various contexts, such as anesthesia for endoscopic procedures, its anticonvulsant effects, or delayed adverse reactions. This literature review presents the characteristics of propofol, its indications, side effects, interactions, and new research directions. Additionally, the study underscores the importance of proper drug storage and management.

Keywords: Propofol, Propofol Infusion Syndrome, Intensive Care Units, Hypnotics and Sedatives, Antiemetics.

© Farm Pol, 2024, 80(3): 205–215