Fospropofol questions

[siednarb]

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I work at an ambulatory surgical center and we are having a major drug shortage with propofol much like the rest of the country.

We are down to our last 25 bottles of propofol despite our attempts at conservation (pushing SAB's more, LMA's for podiatry cases etc...)

We just ordered some fospropofol and I am wondering if anyone has any suggestions on it's use. I've read the Doing Guide put out by the makers of Lusedra - but I have noted that it is only approved for MAC sedation "in patients undergoing diagnostic or therapeutic procedures"

It comes 35 mg/mL and for a 70 Kg individual they recommend 455 mg (13 ml)

is this enough/safe for a GA induction to then give muscle relxatants and/or place and LMA? Just wondering if any of you have used this drug before.

Thanks for any help

 

[Planktonmd]

The pharmacokinetics of this drug are not suitable for induction of GA because it has a delayed onset and that makes estimating the right dose to induce GA very difficult and also makes titrating the drug to achieve a certain level of sedation almost impossible.

I work at an ambulatory surgical center and we are having a major drug shortage with propofol much like the rest of the country.

We are down to our last 25 bottles of propofol despite our attempts at conservation (pushing SAB's more, LMA's for podiatry cases etc...)

We just ordered some fospropofol and I am wondering if anyone has any suggestions on it's use. I've read the Doing Guide put out by the makers of Lusedra - but I have noted that it is only approved for MAC sedation "in patients undergoing diagnostic or therapeutic procedures"

It comes 35 mg/mL and for a 70 Kg individual they recommend 455 mg (13 ml)

is this enough/safe for a GA induction to then give muscle relxatants and/or place and LMA? Just wondering if any of you have used this drug before.

Thanks for any help

 

[Jay K]

Mask induction for everyone that's not RSI.

 

[cchoukal]

I'm starting my faculty post at a VA hospital and apparently the VA nationwide is OUT of propofol (even though the two other hospitals associated with the academic center have propofol falling out of their pockets). They're using etomidate and methohexital. Anyone have any suggestions for methohexital use? Never used it in residency. Not once.

 

[Planktonmd]

I'm starting my faculty post at a VA hospital and apparently the VA nationwide is OUT of propofol (even though the two other hospitals associated with the academic center have propofol falling out of their pockets). They're using etomidate and methohexital. Anyone have any suggestions for methohexital use? Never used it in residency. Not once.

Methohexital dosage is the same as Propofol (1mg Propofol = 1 mg Methohexital).
It's a great induction agent and does not burn at injection.

 

[Idiopathic]

patients go to sleep quickly with methohexital we do ECT with it and it behaves exactly as does propofol in my opinion

 

[DMBFan61]

patients go to sleep quickly with methohexital we do ECT with it and it behaves exactly as does propofol in my opinion

Ugh...I was in ECT land last week...FML

 

[Frank Rizzo]

I agree with everything Plank said about using fospropfol for induction. Its all we have at one of our ASC's, and it is less than ideal.

Wish we had brevital, but I think that is on back-order also.

 

[Jay K]

Has your surgery center considered Fresenius Propoven? They're manufacturing 20mL ampules due to this shortage.