Wednesday, February 21, 2007

Propofol for bronchs

I had posted a long time ago on sedation for bronchs and our preference for propofol. I am at a new hospital and looking to implement a similar protocol (propofol is now generic and much cheaper than a Versed/opiate combo) and in my experience provides more predictable and reliable sedation.
1. Have you used propofol for bronchs?
2. If not what is your default?
3. Do you have any data on either? I have found the following references in support of propofol is somewhat more obscure sources:
1: Acta Anaesthesiol Scand. 2003 Apr;47(4):411-5. Should patients undergoing a bronchoscopy be sedated? Gonzalez R, De-La-Rosa-Ramirez I, Maldonado-Hernandez A, Dominguez-Cherit G.
2: Anasthesiol Intensivmed Notfallmed Schmerzther. 2004 Oct;39(10):597-602. Sedation for fiberoptic bronchoscopy: fewer adverse cardiovascular effects with propofol than with midazolam. Ozturk T, Cakan A, Gulerce G, Olgac G, Deren S, Ozsoz A.
3: Anesth Analg. 2002 May;94(5):1212-6, table of contents. Target-controlled versus manually-controlled infusion of propofol for direct laryngoscopy and bronchoscopy. Passot S, Servin F, Allary R, Pascal J, Prades JM, Auboyer C, Molliex S.

2 comments - CLICK HERE to read & add your own!:

Anonymous said...

Two questions.
1. Do you use continuous drip or iv prn?
2. What is your experience on patients' satisfaction with propafol? Benzos can cause retrograde amnesia and many pts do not remember what happened.

Baleeiro said...

We use intermitent boluses. After the first bolus most patients are out fairly fast.
We have seen excellent amnesia and none of the paradoxical reactions patients can get with benzos.