10 mg/ml, emulsion for injection or infusion, human medicine
Assessed clinical scopeDog · Intravenous induction of general anaesthesia and short monitored maintenance by incremental doses for approximately 30 minutes, or transition to inhalational maintenance. Not analgesia, prolonged ICU sedation or routine serial anaesthesia. · Intravenous
Care settingVeterinary anaesthesia setting with immediate airway control, oxygen, assisted ventilation, IV access and continuous cardiorespiratory monitoring
vetman score
8.1/10
Very good
Evidence confidence: Medium
Georgia: Yes, human · № რ-043326, რ-043327 · Verified on 18 Oct 2026
Off-label use
A very effective, rapidly titratable induction agent and strong short-anaesthesia option when used IV by an equipped veterinary anaesthesia team. The exact human product is off-label but closely supported by an authorised veterinary 10 mg/ml formulation and extensive canine evidence. Its value depends on slow titration to effect, dose reduction after premedication and immediate management of apnoea or hypotension; it provides no analgesia and is not rated here for prolonged infusion.
Regulatory and scientific credibility8.0/10
The exact B. Braun 10 mg/ml MCT/LCT emulsion and both Georgian packs have current sourced human authorisations and a current official regulator RCP. A separate current 10 mg/ml veterinary propofol emulsion is authorised for IV induction and short maintenance in dogs and cats. The exact human product remains off-label and has no located veterinary trial of its specific excipient system.
Clinical efficacy9.0/10
Direct clinical evidence in 290 dogs and the current veterinary label consistently support rapid IV induction, incremental short maintenance or transition to inhalational anaesthesia, with usually smooth recovery. A 2024 randomized clinical study confirmed effective induction and broadly similar early haemodynamics to alfaxalone, although propofol caused a short MAP reduction and fixed dosing was inadequate for intubation in 2/14 dogs. Dose must therefore be titrated to effect and reduced after premedication.
Safety and tolerability7.0/10
Transient apnoea and hypotension are predictable, sometimes intervention-requiring induction risks, but are manageable in the defined equipped setting with titration, airway control and monitoring. Current comparative data found hypotension in 3/12 propofol dogs. Short use is well characterised; prolonged infusion is outside scope because recent cases associate 76-131 hours of exposure with oxidative red-cell injury and Heinz-body anaemia.
Clinical practicality8.5/10
The ready-to-use 10 mg/ml emulsion needs no reconstitution, has rapid onset, is easily titrated through an IV catheter and usually permits quick transition to inhalational maintenance. The 20 ml ampoule suits many canine inductions; larger patients may need multiple ampoules. Strict asepsis, immediate airway readiness, continuous monitoring and disposal of unused single-patient emulsion are mandatory but normal burdens in an anaesthesia service.
Full-course cost-effectiveness-
Price was not assessed and is excluded from the overall score.
Important safety and use flags
- These exact human products are off-label in dogs and cats. Use the veterinary propofol dose framework and anaesthetic endpoint, not a human fixed-dose instruction; record the selected product, concentration and total mg/kg.
- Have a patent-airway plan, oxygen, endotracheal tubes and assisted ventilation immediately available before injection. Transient apnoea is the commonest important induction event; support ventilation rather than waiting for spontaneous recovery when oxygenation or ventilation is inadequate.
- Titrate IV slowly to the clinical endpoint and continuously monitor blood pressure, ECG, pulse quality, SpO2, capnography, respiratory rate and temperature. Premedication and concurrent anaesthetics reduce the required dose; a rapid or excessive bolus increases apnoea and hypotension.
- Propofol is a hypnotic general anaesthetic, not an analgesic. Provide indication-appropriate multimodal analgesia before, during and after painful procedures, while reducing propofol and other depressant doses to the observed response.
- This score covers induction and short maintenance only. Do not extend it to prolonged ICU infusion: accumulation, delayed recovery, infection risk from lipid emulsion and oxidative erythrocyte injury change the benefit-risk balance; five dogs developed suspected Heinz-body anaemia after 76-131 hours of infusion.
- For repeated feline anaesthesia, track exposure dates and total dose, allow more than 48 hours between episodes when feasible, and monitor PCV/CBC, reticulocytes and a blood smear if courses are serial or the cat develops lethargy, anorexia, pallor or prolonged recovery. Clinically important Heinz-body anaemia has occurred after repeated inductions.
- Use strict aseptic technique. Shake gently and inspect the emulsion; do not use it after phase separation. Opened ampoules/vials and prepared syringes are for one patient only, should be used promptly, and unused remainder must be discarded because the lipid emulsion can support microbial growth.
- Do not use after known hypersensitivity to propofol or the exact formulation excipients. Both products contain soya oil and egg phospholipids; Propofol-Lipuro uses an MCT/LCT system, while Diprivan contains disodium edetate. Check the actual pack rather than transferring one product's excipient list to the other.
- Opioids, alpha-2 agonists, benzodiazepines, phenothiazines, inhalational agents and other CNS/cardiorespiratory depressants can deepen anaesthesia and reduce the propofol requirement. Give sequentially to effect, anticipate additive hypotension, bradycardia or respiratory depression and avoid automatic full-dose stacking.
- Safety of these exact human formulations is not established in pregnant or lactating dogs/cats, neonates or severely hypovolaemic, debilitated, cardiac, respiratory, hepatic or renal patients. Stabilise first when possible, use the minimum titrated dose and choose an alternative plan when cardiorespiratory reserve or recovery capacity is poor.
Assessment sources+
