Propofol induced priapism

Priapism following the infusion of propofol has been reported in literature - which may last for hours. Actual mechanism is not known but various theories has been proposed. It may be secondary to lipid content of the drug causing fat emulsion-related increased thrombin, erythrocyte aggregation and/or fat embolism. Vasodilatation, well know with propofol, has also been speculated as a cause of priapism. Another possibility described is the anesthetic effect in the spinal cord that might have blocked the sympathetic vasoconstrictor action or that might have enhanced the parasympathetic vasodilatory action causing an abnormal erection. Propofol-induced alteration of nitric oxide-mediated smooth muscle relaxation might have also had a contributory effect. The modulating effect on GABAa and adrenal steriodogenesis effects of propofol might have also played an additional role.

References:

1. Vesta, Kimi; Shaunta' Martina, Ellen Kozlowski (25 April 2009). "Propofol-Induced Priapism, a Case Confirmed with Rechallenge". The Annals of Pharmacotherapy 40 (5): 980–982.

2. Fuentes, Ennio; Silvia Garcia, Manuel Garrido, Cristina Lorenzo, Jose Iglesias, Juan Sola (July 2009). "Successful treatment of propofol-induced priapism with distal glans to corporal cavernosal shunt". Urology 74 (1): 113–115.