A post hoc descriptive study of patients receiving propofol

BACKGROUND: Use of propofol has recently gained popularity in intensive care settings for patients receiving mechanical ventilation. This newer intravenous sedative is often preferred over other sedatives because of a rapid onset of action, easy titration that allows neurological assessment during administration, and quick arousability of patients after the drug is discontinued. OBJECTIVES: To determine the time to awakening after discontinuance of propofol in a sample of 100 patients receiving mechanical ventilation who had received propofol for at least 12 hours. In addition, demographics, primary and secondary diagnoses, clinical signs and symptoms, propofol dosage and duration, and concomitant use of analgesics and sedatives were determined. METHODS: A descriptive post hoc design was used. Patients' medical records for an 18-month period in an urban hospital in the southwestern United States were reviewed. Sections used for data collection included each patient's admission sheet, the findings of the history and physical examination done by a physician, physicians' progress notes, nursing notes, critical care flow sheets, and records of medications administered. RESULTS: Although nursing documentation indicated 2 common side effects, decreases in heart rate (18%) and decreases in systolic blood pressure (17%), within the first hour of treatment with propofol, immediate arousability after the drug was discontinued was not observed. Mean Glasgow Coma Scale scores took longer than 30 minutes to return to baseline. CONCLUSIONS: The awakening time of patients receiving propofol for a protracted period, usually in conjunction with other potentiating drugs, may be longer than is commonly cited in the literature.