Propofol gtt in PACU?

[Syhuggins]

We recently had a patient in Endoscopy that needed to be tranferred to another facility and the anesthesiologist wanted to start a propofol gtt and transfer the patient to the Surgical PACU setting to await tranfer. Our hospital pharmacy medication management manual does not list PACU as a location permitted to manage a propofol gtt.

The PACU staff has never had any formal education about managing this medication and the anesthesiologist are not consistently in the PACU suite. Considering that this is an anesthetic the question would be is this appropriate for the PACU setting? It's not like the ICU where intensivists are readily available.

Are there facilities that permit PACU nurses to manage a propofol gtt?

If so is anyone able to share their policy/protocol?

[wanderlust99]

yes, but we recover ICU patients in our PACU.

[azhiker96, BSN, RN]

Yes, but only on vented patients with titration orders. The propofol is only for comfort since most people would not tolerate an ETT when they are awake. The vent is the prevent the most obvious adverse effect of apnea/obstruction. However, dosing can also depress cardiac output so you've got to be vigilant.