PROPOFOL SHORTAGE
Recent shortages of propofol have occurred as a direct result of both bacterial
and material contamination. In addition to this shortage, supplies are projected to begin in late December or early January.
There are currently adequate supplies of Methohexital, Ketamine and Etomidate...
The FDA has made available a new agent, Propoven. This agent is different
from propofol in that it is preservative free and contains medium chain
triglycerides as well as long chain triglycerides.
Propoven brand is not labeled with barcodes or NDC numbers.
Gramercy Anesthesia Services has an adequate supply of all anesthetic agents and
is well prepared for any future shortages.
We have provided a list of alternative medications that can be used in your
outpatient center or surgery center on our website, which you may use as a reference point
for alternative induction agents. When using these agents in the office
based setting, it is imperative that an anesthesiologist administer the agents in
a safe environment and under continuous monitoring and care.
Please feel free to contact Gramercy Anesthesia Services if you have any further
questions. Our number is 212-254-3570.
Table 1. Characteristics of injectable agents for anesthesia induction and
maintenance
| Agent | Onset of Action (min) | Clinical Duration (min) | Usual Adult Doses for Anesthesia
Induction and Maintenance |
| Etomidate | < 1 | 3-5 | Induction: 0.2 to 0.6 mg/kg IV (average 0.3 mg/kg IV)
Maintenance: 5-20 mcg/kg/minute IV |
| Ketamine | 1-2 | 5-15 | Induction: 1 to 2 mg/kg IV
Maintenance: 0.33 to 2 mg/kg IV (33-100% of initial dose) as needed |
| Methohexital | < 1 | 3-8 | Induction: 50 to 100 mg IV OR 1 to 1.5 mg/kg IV
Maintenance: 20 to 40 mg IV as needed, usually every 4 to 7 minutes; or 6 mg/minute IV by continuous infusion |
| Propofol | < 1 | 3-8 | Induction: 50 to 100 mg IV OR 1 to 1.5 mg/kg IV
Maintenance: 20 to 40 mg IV as needed, usually every 4 to 7 minutes; or 6 mg/minute IV by continuous infusion |
| Thiopental | < 1 | 4-15 | Induction: 50 to 75 mg IV OR 3 to 5 mg/kg IV, every 20 to 40 seconds
Maintenance: 25 to 100 mg IV as needed (whenever the patient moves) |
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