Propofol: The Most Common Anesthetic Used in Surgery

October 9, 2025 •

4 min read

Propofol is the most widely used intravenous general anesthetic, largely due to its rapid onset and ability to provide a smooth, controlled anesthesia with fewer lingering side effects like nausea and confusion. This makes it a favored option for inducing and maintaining anesthesia across a wide range of surgical procedures.

Quick Summary

This article explores Propofol, the most common intravenous anesthetic, detailing its pharmacological properties, clinical applications, advantages, and key considerations. It also compares Propofol to other common anesthetics like Sevoflurane, highlighting its role in different types of anesthesia, including general anesthesia and sedation.

Key Points

Propofol is the most common anesthetic: It is the most widely used intravenous agent for inducing and maintaining general anesthesia due to its favorable pharmacological profile.
Rapid and predictable effects: Propofol acts quickly to induce unconsciousness and allows for a rapid, clear-headed recovery with less postoperative nausea.
Versatile clinical applications: It is used for general anesthesia, procedural sedation, and long-term sedation in intensive care units.
Balanced anesthesia approach: Propofol is often combined with other drugs like opioids for pain relief and muscle relaxants to achieve a complete anesthetic state.
Requires expert administration and monitoring: Due to its potential effects on blood pressure and breathing, Propofol must be administered by a trained professional in a monitored setting.
Favored over other agents in some cases: Propofol may be preferred over inhalational agents like Sevoflurane when lower postoperative nausea or better hemodynamic stability is desired for specific patient profiles or procedures.

Propofol: The Go-To Anesthetic in the Operating Room

Among the variety of anesthetic agents used in modern medicine, Propofol stands out as the most widely used intravenous (IV) general anesthetic. Its dominant position is a result of several key pharmacological characteristics that make it ideal for anesthesia induction and maintenance. Administered as a milky-white lipid emulsion, Propofol acts quickly, putting patients into a sleep-like state within moments of administration. This rapid onset, combined with a quick recovery profile, is highly beneficial for both patients and healthcare providers.

How Propofol Works and Why It's So Common

Propofol's mechanism of action involves enhancing the inhibitory effects of the neurotransmitter gamma-aminobutyric acid (GABA) within the brain. By boosting GABA's activity, Propofol effectively slows down the central nervous system, leading to a state of unconsciousness. The effect is dose-dependent, meaning the level of sedation can be precisely controlled, from moderate sedation to deep general anesthesia.

Key reasons for Propofol's widespread use include:

Rapid Onset and Short Duration: A bolus injection of Propofol induces unconsciousness within seconds, and its effects wear off relatively quickly after the infusion is stopped. This allows for a more efficient flow in the operating room and is ideal for both short and long procedures.
Favorable Recovery Profile: Patients typically awaken feeling clear-headed, with a low incidence of common postoperative side effects like nausea and vomiting, which can be a significant benefit for patient comfort and faster recovery.
Versatility: Propofol can be used for the induction and maintenance of general anesthesia, for procedural sedation during minor surgeries or diagnostic procedures (like colonoscopies), and for long-term sedation in critically ill patients in intensive care units (ICUs).
Precise Titration: Anesthesiologists can easily adjust the infusion rate of Propofol to control the depth of anesthesia, ensuring the patient remains safely and comfortably unconscious for the duration of the procedure.

Comparing Propofol and Sevoflurane

While Propofol is the most common IV anesthetic, other agents like the inhalational anesthetic Sevoflurane are also frequently used, particularly for the maintenance of anesthesia. The choice between these two often depends on the specific surgical needs and patient characteristics. A comparison helps illustrate their respective roles:


Feature	Propofol	Sevoflurane
Route of Administration	Intravenous (IV) injection or infusion	Inhaled gas delivered via a mask or breathing tube
Onset of Action	Very rapid (seconds)	Rapid, but slightly slower than IV induction
Recovery Time	Generally fast, with clear-headed recovery	Also rapid, though depends on the length of the case
Postoperative Nausea/Vomiting	Low incidence, as Propofol has anti-emetic properties	Higher incidence compared to Propofol
Airway Irritation	Minimal to none	Non-pungent, making it suitable for mask induction in children
Hemodynamic Effects	Can cause more significant hypotension	Generally provides better hemodynamic stability
Primary Use	Induction of general anesthesia, sedation	Maintenance of anesthesia, pediatric induction
Administration Method	Requires an IV line and careful monitoring	Delivered via an anesthesia machine with a vaporizer

Other Anesthetics Used in Conjunction with Propofol

It is important to remember that general anesthesia is rarely achieved with a single drug. Anesthesiologists typically use a combination of medications to create a balanced anesthetic state, which includes unconsciousness (hypnosis), pain relief (analgesia), and muscle relaxation.

Opioids: Drugs like Fentanyl are often given alongside Propofol to provide potent pain relief during surgery.
Muscle Relaxants: Neuromuscular blocking agents, such as Rocuronium, are used to relax the body's muscles, which is crucial for procedures like intubation and major surgery.
Anxiolytics: Medications like Midazolam may be given before surgery to reduce anxiety and promote relaxation.

Considerations and Risks of Propofol

While Propofol is considered safe and effective, its use is not without risks and considerations. It can cause significant drops in blood pressure and suppress breathing in a dose-dependent manner. This necessitates continuous monitoring of the patient's vital signs and skilled management by a trained anesthesia provider. For these reasons, Propofol is only administered by qualified healthcare professionals in monitored settings.

One rare but serious complication is Propofol Infusion Syndrome (PRIS), which is typically associated with prolonged, high-dose infusions, primarily in critically ill patients. However, with appropriate dosing and monitoring, the benefits of Propofol far outweigh the risks for most surgical procedures.

Conclusion

Propofol's reign as the most common anesthetic used in surgery is well-deserved. Its rapid, controllable, and predictable effects, coupled with a favorable recovery profile, have made it an indispensable tool for anesthesiologists worldwide. Whether used for induction in a major operation or for sedation in a minor procedure, Propofol provides a consistent and safe anesthetic experience. By understanding its role in the anesthetic process, patients can feel more confident and informed about the medications used to ensure their comfort and safety during surgery. Further advancements in pharmacology continue to refine anesthetic techniques, but Propofol remains a benchmark for its class.

Frequently Asked Questions

Propofol is widely used because it has a rapid onset of action and allows for a quick and clear-headed recovery. This helps reduce patient recovery time and minimizes common side effects like postoperative nausea and vomiting.

No, general anesthesia is typically achieved using a combination of drugs. Propofol is often used to induce anesthesia (put the patient to sleep), but other medications, such as inhaled anesthetics, opioids for pain, and muscle relaxants, are also used to maintain a stable anesthetic state.

Propofol is an intravenous (IV) anesthetic, while Sevoflurane is an inhalational anesthetic (a gas). The choice often depends on the specific surgical needs, as Propofol offers rapid induction and less nausea, whereas Sevoflurane can provide better hemodynamic stability in some cases.

It can be both. At lower doses, Propofol is used for sedation, helping a patient relax during minor procedures. At higher doses, it induces the deep, sleep-like state required for general anesthesia.

Like any powerful drug, Propofol has risks. It can cause a drop in blood pressure and suppress breathing, which is why it must be administered by a qualified professional in a carefully monitored setting. A very rare but serious complication, PRIS, is associated with prolonged, high-dose infusions.

Propofol is administered by highly trained medical professionals, such as anesthesiologists and certified registered nurse anesthetists (CRNAs), who are specialized in delivering anesthesia and monitoring patients during procedures.

Propofol is commonly used in both adults and children for anesthesia induction and sedation. However, the dosage and administration for children are carefully managed based on their specific needs and age.