Propofol for the long-term sedation of a critically ill patient.
OBJECTIVE
To report a case in which propofol was used successfully in an intubated patient on a prolonged basis and to review the literature that discusses long-term infusions (> 7 days) of propofol.


METHODS
Information was retrieved from a MEDLINE search of the English-language literature. Reports of clinical trials and case reports that compared the safety and efficacy of long-term propofol and midazolam were included in this review. Information about the study design and the efficacy and adverse effects of the drugs was collected, and the data were synthesized.


RESULTS
Clinical reports indicate that a long-term infusion of propofol is comparable in safety and efficacy to a long-term infusion of midazolam. The distinct adverse-effect profile of long-term use of propofol, including hypertriglyceridemia, was evaluated and reported as significant.


CONCLUSIONS
The limited data available suggest that long-term infusion of propofol is a practical alternative to use of standard agents for sedation of intubated patients. Adverse effects such as cardiovascular depression, respiratory depression, and hypertriglyceridemia may limit the routine use of propofol.
Miller
L J
LJ
Department of Pharmacy, Washington Regional Medical Center, Fayetteville, Ark., USA.
Wiles-Pfeifler
R
R
D000328:Adult; D016292:Procedural Sedation; D003422:Critical Care; D016638:Critical Illness / Q000628:therapy*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D008297:Male; D010195:Pancreatitis / Q000628:therapy; D010437:Peptic Ulcer / Q000628:therapy; D015742:Propofol / Q000009:adverse effects / Q000627:therapeutic use*
D006993:Hypnotics and Sedatives; D015742:Propofol