Propofol

Propofol enhances GABA_A receptor-mediated inhibition in the central nervous system. My shorthand calls it a GABA agonist. It does not mean that propofol makes more GABA.

The emulsion in my notes contains soybean oil, glycerol and egg lecithin. It can support bacterial growth. The warning not to reuse it over time belongs to the exact product's handling instructions. Preservative-free and preserved preparations are different.

The 28-day cue refers to the benzyl-alcohol-preserved PropoFlo28 formulation after first opening. Its US label is for dogs. Strict aseptic handling still matters, and suspected contamination is a reason to discard it. A preservative is not a guarantee of sterility. The label warns that benzyl alcohol may be toxic to cats. A single-dose study in six healthy cats found minimal differences between formulations; that does not establish repeated-dose, infusion or diseased-cat safety.

Repeated propofol exposure in cats can cause malaise and oxidative red-cell damage with Heinz bodies. One original includes “subclinical anaemia”; the duplicate leaves that phrase out. The textbook says oxidative changes do not induce anaemia, but the reported effects vary with the protocol. Short studies often found small changes. A later single-cat report described clinically important Heinz-body anaemia after repeated inductions. That case does not measure incidence or prove the same outcome in every cat.

Propofol is rapidly redistributed and has extrahepatic sites of metabolism. This helps explain the source's liver-disease cue, but does not prove safety in every hepatic patient. The original advises avoiding the benzyl-alcohol form. The current PropoFlo28 label says use in renal or hepatic failure has not been evaluated.

References

Johnston & Tobias, 2nd ed., Ch21; PropoFlo28 US label; Griffenhagen2015; Andress1995; Bley2007; Matthews2004; Baetge2020 case.