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Anästhesiol Intensivmed Notfallmed Schmerzther 2013; 48(6): 378-385
DOI: 10.1055/s-0033-1349000
Fachwissen
Anästhesie
© Georg Thieme Verlag Stuttgart · New York

Propofol up2date – Teil 1: Geschichte und pharmakologische Charakteristika

Propofol up2date
Stefan Bushuven
,
Daniel Heise
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Publication History

Publication Date:
04 July 2013 (online)

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Propofol ist das am weitesten verbreitete Hypnotikum in der Anästhesiologie und Intensivmedizin und wird auch durch andere Disziplinen für die Sedierung im Rahmen diagnostischer und interventioneller Eingriffe eingesetzt. Trotz seiner Verbreitung sind den Anwendern nicht immer alle pharmakokinetischen und -dynamischen Eigenschaften, Nebenwirkungen und Kontraindikationen dieser facettenreichen Substanz präsent und bezüglich einiger Anwendungsbereiche bestehen Kontroversen und teilweise ungerechtfertigte Vorbehalte. Propofol ist ein hochpotentes Hypnotikum mit einer Vielzahl an (un)erwünschten Nebenwirkungen, die im folgenden Übersichtsartikel zusammengefasst werden sollen.

Propofol is a common hypnotic agent in anaesthesiology and intensive care medicine and for procedural sedation as well. Despite the intensive usage the full potential, pharmacokinetic and –dynamic abilities, interactions and side effects of the substance may not be realized by all providers. Additionally there is dispute and unwarranted myth about the substance. Propofol is a highly potent hypnotic with a wide range of (un)desired effects. This article is reviewing the diversity of the substance in clinical practice.

Kernaussagen

  • Propofol ist stark lipophil und wird mit einer Trägeremulsion aus Sojaöl, Lecitihin, Glycerol und Natriumhydroxid verabreicht.

  • Die Propofolemulsion sollte nicht mit anderen Substanzen vermischt werden.

  • Propofol stimuliert GABA-A-, GABA-B- und Dopamin-1-Rezeptoren, blockiert NMDA-Rezeptoren und moduliert eine Vielzahl von Elektrolytkanälen. Hierdurch werden dosisabhängig euphorisch-enthemmende bis sedierend-hypnotische Effekte erzielt.

  • Propofol diffundiert schnell aus dem Blutkreislauf in blutreiche Organe und von dort weiter in periphere Kompartimente. Diesem liegt ein 3-Kompartiment-Modell zugrunde.

  • Die Substanz wird mikrosomal eliminiert.

  • Propofol vermindert das Risiko für postoperative Übelkeit und Erbrechen.

  • Propofolabusus ist v. a. im medizinischen Bereich verbreitet und führt häufig zu akzidentellen Todesfällen.

Ergänzendes Material

 

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