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[thachanesthetist]

Hi everybody,

Today I read an review article "Propofol infusion syndrome" (PIRS) of authors P.C.A. Kam and d. Cardone published on Anaesthesia Volume 62, Number 7, July 2007.
The authors recommended that a propofol infusion rate of greater than 4mg/kg/h for longer than 48h should be avoided because a number of serious adverse effects such as metabolic acidosis, cardiac asystole, myocardial failure, rhabdomyolysis, and death. 
Therefore, I want to know what drugs should be replaced to Propofol to infusion for long- term in operating room and intensive care unit and how to use them.
Thanks for your help.

[hillpeng]

come back,  haha .its procaine

[swatantramishra]

Ideally speaking all the sedation should be stopped for a while -something which is known as sedation vacation, this in general should take care of majority of complication along with reducing complication of mechanical ventilation ( like VAP,delayed recovery etc.). Also we can change propofol to benzodiazapines and back if the need be, of couse the main menu in such cases is opioids but for anxiolysis and sedation benzodiazapines are good choices. Even dexmedetomedinies can be used for shorter period as change over drugs.

come back,  haha .its procaine