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Published Online, 25 April 2006, www.theannals.com, DOI 10.1345/aph.1G555.
 The Annals of Pharmacotherapy: Vol. 40, No. 5, pp. 980-982. DOI 10.1345/aph.1G555
© 2006 Harvey Whitney Books Company.
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Propofol-Induced Priapism, a Case Confirmed with Rechallenge

Kimi S Vesta, PharmD BCPS

Assistant Professor, Department of Pharmacy, Clinical and Administrative Sciences, College of Pharmacy, University of Oklahoma, Oklahoma City, OK

Shaunta' D Martina, PharmD

Internal Medicine Pharmacy Practice Resident, Department of Pharmacy, Clinical and Administrative Sciences, College of Pharmacy, University of Oklahoma

Ellen A Kozlowski, DPh

Pharmacy Clinical Coordinator, Department of Pharmacy, OU Medical Center, Oklahoma City

Reprints: Dr. Vesta, College of Pharmacy, PO Box 26901, Oklahoma City, OK 73190-5040, fax 405/271-6430, Kimi-Vesta{at}ouhsc.edu

OBJECTIVE: To report a case of propofol-induced priapism.

CASE SUMMARY: A 17-year-old male receiving propofol for induction of anesthesia during a cardiac ablation procedure developed priapism that required medical intervention and discontinuation of propofol. The priapism developed after a total propofol dose of 550 mg, lasted for 2 hours, and resolved immediately following medical intervention. The following day, the patient underwent a transesophageal echocardiogram and received a total propofol dose of 40 mg throughout the procedure. He again developed priapism, which resolved within one hour without medical intervention.

DISCUSSION: Priapism experienced by this patient is considered to be drug-induced because of the temporal relationship, recurrence with rechallenge, and dose-response relationship. Using the Naranjo probability scale, we determined that propofol was a highly probable causative agent of priapism in this patient.

CONCLUSIONS: Although, as of April 4, 2006, this adverse effect has not been previously reported, there is a strong correlation of propofol to priapism in this patient. Clinicians should be aware of this adverse effect.

Key Words: priapism, propofol

Published Online, April 25, 2006. www.theannals.com, DOI 10.1345/aph.1G555




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