Propofol in ICU Settings: Understanding and Managing Anti-Arrhythmic, Pro-Arrhythmic Effects, and Propofol Infusion Syndrome
Jananthan Paramsothy, Sai Dheeraj Gutlapalli, Vijay Durga Pradeep Ganipineni, Isabelle Mulango, Ikpechukwu J Okorie, Divine Besong Arrey Agbor, Crystal Delp, Hanim Apple, Borislav Kheyson, Jay Nfonoyim, Nidal Isber, Mallikarjuna Yalamanchili
Abstract
Propofol has revolutionized anesthesia and intensive care medicine owing to its favorable pharmacokinetic characteristics, fast onset, and short duration of action. This drug has been shown to be remarkably effective in numerous clinical scenarios. In addition, propofol has maintained an overwhelmingly favorable safety profile; however, it has been associated with both antiarrhythmic and proarrhythmic effects. This review concisely summarizes the dual arrhythmic cardiovascular effects of propofol and a rare but serious complication, propofol infusion syndrome (PRIS). We also discuss the need for careful patient evaluation, compliance with recommended infusion rates, and vigilant monitoring.