Induction and Maintenance of General Anesthesia
Adult Patients (Younger Than 55 Years of Age).
For induction of anesthesia, the manufacturers recommend that patients with ASA Physical Status I or II who have not been premedicated or those who received premedication with oral benzodiazepines or IM opiate agonists usually should receive 40 mg (2–2.5 mg/kg) of propofol every 10 seconds according to the patient’s response, until onset of induction.
For maintenance of anesthesia in patients undergoing general surgery, the usual initial IV infusion rate of propofol is 100–200 mcg/kg per minute (6–12 mg/kg per hour), administered concomitantly with inhaled 60–70% nitrous oxide and oxygen. Immediately following induction, higher IV infusion rates of 150–200 mcg/kg per minute generally may be required for the first 10–15 minutes, and then decreased by 30–50% during the first 30 minutes of maintenance anesthesia. The manufacturers state that IV infusion rates of 50–100 mcg/kg per minute usually are used to optimize recovery times.
Alternatively, for maintenance anesthesia, healthy adults may receive propofol doses of 20–50 mg by intermittent IV injection in combination with inhaled nitrous oxide. Additional IV doses of 20–50 mg may be given if necessary, as determined by changes in vital signs (increases in pulse rate, blood pressure, sweating and/or lacrimation) indicating response to surgical stimulation or lightening of anesthesia.
