Hannu Kokki1, Ulla Närhi. 1. Department of Anaesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland.
Abstract
BACKGROUND: Propofol is approved both for anaesthesia and sedation during intensive care. Serious adverse reactions with propofol have recently been reported, but patient exposure to the drug is unknown. OBJECTIVE: To investigate the consumption of propofol in Finnish hospitals and to develop a denominator to estimate patient exposure. METHODS: The consumption of propofol was investigated using the drug consumption database for 1990-2001. Distribution between anaesthesia and intensive care use in Finnish hospitals was investigated by a survey covering the period 2000-2001. We based the estimate of patient exposure on doses commonly described in the literature on propofol use in different indications. RESULTS: Total consumption of propofol increased more than 4-fold from 1990-2001. Most of the propofol consumed was the 10 mg/mL strength. In 2001, one-third of the total sales consisted of the 20 mg/mL strength. In 2000 and 2001, a little more than half of the total consumption of propofol was used for sedation in intensive care. CONCLUSION: The use of propofol is increasing in Finland. Half of the propofol was used in anaesthesia units and half in intensive care units. We propose the following defined daily doses: 175mg for anaesthesia induction; 750 mg/patient-hour for anaesthesia maintenance; and 4200 mg/patient-day for sedation in intensive care.M.
BACKGROUND:Propofol is approved both for anaesthesia and sedation during intensive care. Serious adverse reactions with propofol have recently been reported, but patient exposure to the drug is unknown. OBJECTIVE: To investigate the consumption of propofol in Finnish hospitals and to develop a denominator to estimate patient exposure. METHODS: The consumption of propofol was investigated using the drug consumption database for 1990-2001. Distribution between anaesthesia and intensive care use in Finnish hospitals was investigated by a survey covering the period 2000-2001. We based the estimate of patient exposure on doses commonly described in the literature on propofol use in different indications. RESULTS: Total consumption of propofol increased more than 4-fold from 1990-2001. Most of the propofol consumed was the 10 mg/mL strength. In 2001, one-third of the total sales consisted of the 20 mg/mL strength. In 2000 and 2001, a little more than half of the total consumption of propofol was used for sedation in intensive care. CONCLUSION: The use of propofol is increasing in Finland. Half of the propofol was used in anaesthesia units and half in intensive care units. We propose the following defined daily doses: 175mg for anaesthesia induction; 750 mg/patient-hour for anaesthesia maintenance; and 4200 mg/patient-day for sedation in intensive care.M.