Propofol is currently the hypnotic drug of choice for anesthetic induction. With the increase in TIVA anesthesia, Propofol is also being used as a maintenance drug. Propofol is a lipid preparation which incorporates egg lecitin, phosphatide and soy oil in the preparation. Egg and Soy allergies are listed as contraindication to the use of propofol. Due to the presence of egg products in the formula, the question emerges as to whether or not propoful should be used in the patient with egg allergy.
In a retrospective chart review study by Murphy A, et al published in Anasth Analg the topic of propofol use in the egg allergic patient is explored. The authors report that egg lecithin used in the propofol formulation has not been found to have residual egg proteins. The literature revealed only one case where an egg allergic patient reacted to the lecithin used in propofol. Since egg lecithin comes from the egg yolk, the authors speculate that up to 75% of pediatric patients with egg allergy could tolerate Propofol without incident. Nevertheless, the authors recommend skin testing of patients with egg allergy prior to propofol use.
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