Discussion on Proper Use of Propofol

Abstract

The pros & cons and proper use of the intravenous anesthetic propofol in children was discussed at the 38th Annual Meeting of the Japan Society for Clinical Anesthesia. A 2-year-old boy who underwent surgery for cervical lymphangioma in February 2014 died due to acute circulatory failure resulting from propofol infusion syndrome（PRIS）three days later in the intensive care unit（ICU）. The use of propofol in children under mechanical ventilation in the ICU is contraindicated in JAPAN. PRIS has also been reported in adults. Rapid intravenous flash injection during continuous administration of 1% propofol during artificial ventilation management is also prohibited in ICUs in Japan. Propofol and its solvent lipids increase the risk of embolism and mitochondrial injury in ICU management. It is necessary to pay attention to blood concentration and administration period during continuous infusion of propofol. We look forward to a full review and proper revision of user’s manuals for many intravenous drugs in the field of anesthesiology by the Ministry of Health, Labor and Welfare and the Pharmaceuticals and Medical Devices Agency in Japan.