Emergency and Critical Care

Propofol Infusion Rate Calculator

Calculates propofol infusion rate (mL/h) from dose and emulsion concentration (1% or 2%).

Primary source: Российские КР по анестезиологии и седации в ОРИТ. PADIS Guidelines 2018.

Aleksandr A. Aulov, MD, internal medicine Last clinical review: April 28, 2026

Online calculation

Patient weight

Body weight

Propofol dose

Sedation 1–3 mg/kg/h; general anesthesia 4–12 mg/kg/h

mg/kg/h

Emulsion concentration

Printed on the vial

About this score

Propofol is the standard sedative agent in the ICU and outpatient anesthesiology. The 1% emulsion (10 mg/mL) is the standard vial (20–100 mL); the 2% emulsion (20 mg/mL) is a concentrated formulation for prolonged infusion in larger volumes. The ready-to-use solution is administered without dilution, which simplifies dosing and reduces the risk of errors.

ICU sedation doses: 1–3 mg/kg/h (RASS −1 / −2, standard for mechanically ventilated patients); 3–6 mg/kg/h (RASS −3 / −4, deep sedation); 4–12 mg/kg/h (general anesthesia). For anesthesia induction, 1–2.5 mg/kg bolus (not included in this calculator, which is for continuous infusion).

The main warning is propofol infusion syndrome (PRIS): at doses > 4 mg/kg/h for more than 48 hours, metabolic acidosis, rhabdomyolysis, acute kidney injury, hyperlipidemia, and arrhythmias may occur. Monitoring: arterial blood gas, lactate, CK, and triglycerides every 24 hours during prolonged sedation.

When to use

Sedation of mechanically ventilated patients in the ICU (standard first-line agent).
Maintenance of general anesthesia (TIVA, total intravenous anesthesia).
Sedation for invasive procedures (EGD, colonoscopy, cardioversion).
Control of refractory status epilepticus (resistant to standard therapy), high doses under EEG monitoring.

Clinical example

Case

70 kg man in the ICU, mechanically ventilated after thoracic surgery. Target RASS −1 / −2 for ventilator synchrony. Propofol 2 mg/kg/h prescribed, 1% emulsion.

Calculation

1% emulsion = 10 mg/mL. Rate: 70×2/10 = 14 mL/h.

Interpretation and management

Standard sedation for a mechanically ventilated patient. Monitor RASS every 4 hours; perform a daily protocolized sedation vacation to assess readiness for extubation. If duration exceeds 48 hours, monitor blood gas, CK, and triglycerides for PRIS. Consider switching to dexmedetomidine if both dose and duration are high.

Limitations and cautions

Hypotension is a typical adverse effect, especially in hypovolemic patients; blood pressure may drop by 20–30% at standard doses.
Propofol infusion syndrome (PRIS) is a rare but potentially fatal complication at high doses and prolonged infusion. Monitor blood gas, CK, and lactate.
Hypertriglyceridemia (the emulsion contains soybean oil): monitor every 2–3 days during prolonged infusion. At ≥5 mmol/L, switch to an alternative agent.
Allergy to egg lecithin or soybean oil (rare).

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Frequently asked questions

Propofol vs dexmedetomidine in the ICU?

Dexmedetomidine does not suppress respiration and is associated with a lower incidence of delirium and earlier extubation. Propofol has a faster onset and produces deeper sedation. Per the PADIS 2018 guidelines, dexmedetomidine is preferred for mechanical ventilation lasting more than 48 hours.

What is RASS, and what is the target level?

The Richmond Agitation-Sedation Scale ranges from +4 (combative) to −5 (unarousable). In most cases the target is −1 / −2 (light sedation, responsive to stimulation). −4 / −5 corresponds to deep sedation for severe pathology.

When should PRIS be suspected?

Unexplained metabolic acidosis plus elevated CK plus cardiac dysfunction plus hyperlipidemia in a patient on propofol for more than 48 hours at a dose > 4 mg/kg/h. Immediate discontinuation and supportive therapy (bicarbonate, renal replacement therapy for AKI).

Which concentration should be chosen, 1% or 2%?

1% is standard for most cases and for short procedures. 2% is used for prolonged sedation (> 48 hours) to reduce infusion volume and lipid load.

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Aleksandr A. Aulov Physician, internal medicine, Sechenov School — independent medical education platform. Calculators are compiled from the original publications and current clinical guidelines. Interpretation thresholds follow the source study unless stated otherwise.

This calculator is intended for healthcare professionals. Do not use it for self-diagnosis or self-treatment. Management decisions are made by the treating clinician based on the full clinical picture of the individual patient.