Comparison of Propofol Versus Ketamine for Anesthesia in Pediatric Patients Undergoing Cardiac Catheterization

Lebovic, Saul; Reich, David L.; Steinberg, L L; Vela, F P; Silvay, George

doi:10.1213/00000539-199204000-00003

Cited by 121 publications

(62 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Propofol anesthesia was well tolerated, and the mean time from entry to discharge from the recovery room was 39 minutes. In a study comparing propofol anesthesia with ketamine anesthesia in nonintubated pediatric patients undergoing cardiac catheterization, 20 a transient decrease in mean arterial blood pressure Ͼ20% from baseline occurred in 70% of patients on induction of propofol anesthesia, as well as a decrease in oxygen saturation of 5 to 10 percentage points in 40% of patients. The time to full recovery from propofol anesthesia was 24 Ϯ 19 minutes.…”

Section: Discussionmentioning

confidence: 99%

“…Propofol (2,6 diisopropylphenol) is an intravenously administered anesthetic that has a rapid onset of action and a dose-dependent degree of anesthetic activity that dissipates quickly with the discontinuation of drug administration. Propofol also is an antiemetic and commonly results in a clear-headed emergence from anesthesia.…”

mentioning

confidence: 99%

“…4,5 Propofol has been used extensively for pediatric anesthesia in the operating room with excellent success. 4 Because of its favorable properties and the limited anesthesia and operating room resources available in some centers, there has been increasing interest in the use of propofol anesthesia to facilitate procedures of short duration in children in areas outside of the operating room, such as for cardiac catheterization, 6 magnetic resonance imaging, 7 and elective cardioversion in the pediatric intensive care unit (PICU). 8 These experiences suggest that propofol is an effective anesthetic for these procedures but that important side effects, most notably respiratory depression and hypotension, may occur, necessitating close cardiorespiratory monitoring and the attendance of personnel skilled in cardiorespiratory support.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Propofol Anesthesia for Invasive Procedures in Ambulatory and Hospitalized Children: Experience in the Pediatric Intensive Care Unit

et al. 1999

View full text Add to dashboard Cite

ABSTRACT. Objectives. To describe our experience with propofol anesthesia to facilitate invasive procedures for ambulatory and hospitalized children in the pediatric intensive care unit (PICU) setting.Methods. We retrospectively reviewed the hospital records of 115 children who underwent 251 invasive procedures with propofol anesthesia in our multidisciplinary, university-affiliated PICU during a 20-month period. All patients underwent a medical evaluation and were required to fast before anesthesia. Continuous monitoring of the patient's cardiorespiratory and neurologic status was performed by a pediatric intensivist, who also administered propofol in intermittent boluses to obtain the desired level of anesthesia, and by a PICU nurse, who provided written documentation. Data on patient demographics, procedures performed, doses of propofol used, the occurrence of side effects, induction time, recovery time, and length of stay in the PICU were obtained.Results. Propofol anesthesia was performed successfully in all children (mean age, 6.4 years; range, 10 days to 20.8 years) who had a variety of underlying medical conditions, including oncologic, infectious, neurologic, cardiac, and gastrointestinal disorders. Procedures performed included lumbar puncture with intrathecal chemotherapy administration, bone marrow aspiration and biopsy, central venous catheter placement, endoscopy, and transesophageal echocardiogram. The mean dose of propofol used for induction of anesthesia was 1.8 mg/kg, and the total mean dose of propofol used was 8.8 mg/kg. In 13% of cases, midazolam also was administered but did not affect the doses of propofol used. The mean anesthesia induction time was 3.9 minutes, and the mean recovery time from anesthesia was 28.8 minutes for all patients. The mean PICU stay for ambulatory and ward patients was 140 minutes. Hypotension occurred in 50% of cases, with a mean decrease in systolic blood pressure of 25%. The development of hypotension was not associated with propofol doses, the concomitant use of midazolam, or the duration of anesthesia, but was associated with older patient age. Hypotension was transient and not associated with altered perfusion. Intravenous fluid was administered in 61% of the cases in which hypotension was present. Respiratory depression requiring transient bag-valve-mask ventilation occurred in 6% of cases and was not associated with patient age, propofol doses, concomitant use of midazolam, or the duration of anesthesia. Transient myoclonus was observed in 3.6% of cases. Ninety-eight percent of procedures were completed successfully, and no procedure failures were considered secondary to the anesthesia. Patients, parents, and health care providers were satisfied with the results of propofol anesthesia.Conclusions. Propofol anesthesia can safely facilitate a variety of invasive procedures in ambulatory and hospitalized children when performed in the PICU and is associated with short induction and recovery times and PICU length of stay. Hypotension, although usually transien...

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Propofol Anesthesia for Invasive Procedures in Ambulatory and Hospitalized Children: Experience in the Pediatric Intensive Care Unit

et al. 1999

View full text Add to dashboard Cite

show abstract

“…It has been reported that less pediatric patients have experienced significant MAP decreases (＞ 20% compared to baseline) during induction when ketamine, but not propofol, is used [17]. In this study, MAP was increased after the injection of ketamine.…”

Section: Discussionmentioning

confidence: 51%

Effects of thiopental sodium, ketamine, and propofol on the onset time of rocuronium in children

Jung

Kim²,

Choi

et al. 2017

Anesth Pain Med

View full text Add to dashboard Cite

“…Furthermore, propofol has been reported to exhibit dose-dependent cardiodepressive effects 4 . Thus, propofol is commonly used in combination with other drugs that provide adequate analgesia 5 .…”

Section: Introductionmentioning

confidence: 99%

Combined Neuroprotective Effects of Propofol and Dexmedetomidine on Endoplasmic Reticulum Stress-mediated Apoptosis in SH-SY5Y Cells

Somei

Inagaki

Oguchi

et al. 2016

Showa Univ J Med Sci

View full text Add to dashboard Cite

: Propofol is a short-acting intravenous anesthetic agent. Dexmedetomidine, a highly selective 2 -adrenergic receptor agonist, has a well-known sedative effect. Both agents exhibit cytoprotective effects in the nervous system under ischemic conditions. Recently, the combination of propofol plus dexmedetomidine was used for the sedation of mechanically ventilated patients in an intensive care unit, but there are few experimental reports of the protective effects of the propofol plus dexmedetomidine combination in cells. Meanwhile, intraoperative brain ischemia-reperfusion induces endoplasmic reticulum ER stress-mediated apoptosis. The aim of the present study was to clarify molecular details underlying the neuroprotection afforded by the combination of propofol plus dexmedetomidine against thapsigargin TG -induced ER stress in human neuroblastoma SH-SY5Y cells, and whether the combination provided more ef cient neuroprotection. TG was used to generate ER stress in SH-SY5Y cells. Cells were pretreated with propofol or dexmedetomidine, individually or in combination, for 1 h before cotreatment with TG for 20 h. There was a signi cant increase in Ca 2 i , caspase activation, and the expression of ER stress biomarkers in TG-induced apoptotic cells. The increase in Ca 2 i and the induction of ER stress by TG were suppressed by pretreatment with propofol, dexmedetomidine, and their combination. The dexmedetomidineinduced reduction in caspase activity and ER stress biomarkers was inhibited by pretreatment with an 2 -adrenergic receptor antagonist, but was enhanced by pretreatment with a cAMP inhibitor. Treatment with the propofol plus dexmedetomidine combination exhibited the strongest protection against TG-induced apoptosis. These results demonstrate that the combination of propofol plus dexmedetomidine at clinically relevant concentrations suppresses ER stress-induced apoptosis in neuroblastoma SH-SY5Y cells. The ndings suggest that the combination of propofol plus dexmedetomidine within a clinically relevant concentration range may be used safely in patients.

show abstract

Comparison of Propofol Versus Ketamine for Anesthesia in Pediatric Patients Undergoing Cardiac Catheterization

Cited by 121 publications

References 0 publications

Propofol Anesthesia for Invasive Procedures in Ambulatory and Hospitalized Children: Experience in the Pediatric Intensive Care Unit

Propofol Anesthesia for Invasive Procedures in Ambulatory and Hospitalized Children: Experience in the Pediatric Intensive Care Unit

Effects of thiopental sodium, ketamine, and propofol on the onset time of rocuronium in children

Combined Neuroprotective Effects of Propofol and Dexmedetomidine on Endoplasmic Reticulum Stress-mediated Apoptosis in SH-SY5Y Cells

Contact Info

Product

Resources

About