Propofol can cause airway obstruction, as well as severe respiratory depression leading to hypoxia. Propofol is known to cause profound reductions in tidal volume, a decrease in the inspiratory cycle (Ti:Ttotal), and, interestingly, an early tachypnea. Furthermore, propofol is known to depress the hypoxic ventilatory response even in sedative doses. At induction doses (generally 1.5 – 3 mg/kg depending on age and comorbidities), apnea generally occurs within 30 seconds and can last 5 minutes or longer. Although the neurologic mechanisms by which propofol causes respiratory depression have yet to be fully elucidated, studies in rats have shown that propofol exerts a depressive effect on neurons in the medullary respiratory center via GABA receptor-mediated hyperpolarization.
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