Propofol Bradycardia

Bradycardia and asystole have been observed after induction of anesthesia with propofol. The risk of propofol bradycardia related death during propofol anesthesia has been estimated to be 1.4 in 100,000.

Severe, refractory, and fatal bradycardia has been observed with long-term propofol bradycardia infusion. In contrast to thiopentone, propofol apparently lacks central vagolytic activity and may exert a central vagotonic effect which can exaggerate the muscarinic effects of suxamethonium.

Propofol does not alter sinoatrial or atrioventricular node functidh. Propofol causes prolongation of the QT interval and results in a higher incidence of bradycardia and junctional rhythm than the barbiturates.

Treatment of propofol-induced bradycardia may require treatment with a beta-agonist such as isoproterenol.

Propofol prevents rise in blood pressure more effectively than thiopental during laryngoscopy and intubation but still has some propofol bradycardia death effects due to improper use.

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