Propofol vs. Benzos with NMBAs

[John Detter]

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All the clinical pharmacists at my institution make it a regular practice to recommend a benzo drip over propofol for patients on a neuromuscular blocking agent because supposedly they think that benzos have a more powerful amnestic properties. However when I do my own literature search and Googling, I'm not finding much literature to support the recommendation. Additionally, I found protocols from many other institutions that include propofol. Am I missing something, and does someone have any articles that they can direct me to?

 

[Dred Pirate]

All the clinical pharmacists at my institution make it a regular practice to recommend a benzo drip over propofol for patients on a neuromuscular blocking agent because supposedly they think that benzos have a more powerful amnestic properties. However when I do my own literature search and Googling, I'm not finding much literature to support the recommendation. Additionally, I found protocols from many other institutions that include propofol. Am I missing something, and does someone have any articles that they can direct me to?

we do prop with appropriate bis monitoring

 

[sakigt]

Propofol is preferred here

 

[rl123]

no BIS available in our ICU
- when it's for targeted temperature management and there's a hard stop for paralytics (if even required for shivering), we always use propofol.
- For severe cases of ARDS in an obese patient (high volumetric rates of propofol delivered), some attendings pick a benzo drip over propofol bc they might keep the patient paralyzed >48 hrs (this is another story...), and they worry that they'll run into a triglyceride issue during paralysis and don't want to be pushed into a situation where propofol isn't suitable anymore during paralysis

 

[BidingMyTime]

This must be something new, I've never heard of this. It sounds completely anecdotal that benzos have more amnestic properties than propofol.