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Propofol cardiovascular effects — FRCA Primary MCQ

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ModeratePharmacologyPropofol cardiovascular effectsFRCA Primary

A 32-year-old man is anaesthetised with a propofol infusion for a short shoulder arthroscopy. Shortly after induction, his arterial pressure falls from 128/76 mmHg to 86/48 mmHg while heart rate remains 62 min-1. What is the most likely explanation?

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Correct answer: E — Reduced systemic vascular resistance with impaired baroreflex tachycardia

Propofol commonly causes hypotension by vasodilatation and myocardial depression, with a blunted baroreflex response. Histamine release is more characteristic of some opioids and atracurium, not the usual mechanism of propofol hypotension. Ketamine, rather than propofol, is associated with sympathetic stimulation. The useful teaching point is that propofol induction should be titrated carefully in hypovolaemic, elderly or shocked patients.

Reference: RCoA Primary FRCA Syllabus 2026; Peck, Hill & Williams Pharmacology for Anaesthesia