Side Effects

Nervous System The CNS effects of propofol are similar to those of barbiturates, but, unlike thiopental, propofol is not a proven acute intervention for seizures.

Cardiovascular Propofol produces a dose-dependent decrease in blood pressure that is significantly greater than that produced by thiopental; the effect is explained by vasodilation and mild depression of myocardial contractility. Propofol appears to blunt the baroreceptor reflex or is directly vagotonic. As with thiopental, propofol should be used with caution in patients at risk for or intolerant of decreases in blood pressure.

Respiratory and Other Side Effects At equipotent doses, propofol produces a slightly greater degree of respiratory depression than thiopental. Patients given propofol should be monitored to ensure adequate oxygenation and ventilation. Propofol has significant antiemetic action and is a good choice for sedation or anesthesia of patients at high risk for nausea and vomiting. Propofol provokes anaphylactoid reactions and histamine release at about the same low frequency as thiopental. Propofol is considered safe for use in pregnant women, and like thiopental, only transiently depresses activity in the newborn.

Etomidate

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