Incidence of Adverse Effects of Propofol for Procedural Sedation/Anesthesia in the Pediatric Emergency Population: A Systematic Review and Meta-Analysis

Guo, Pengfei; Ran, Yingchun; Ao, Xiaoxiao; Zou, Qing; Tan, Liping

doi:10.1155/2021/3160154

Cited by 4 publications

(5 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Its induction in the respiratory system can lead to respiratory depression, bronchospasm, laryngospasm, and apnea. In the cardiovascular system, propofol injection can result in hypotension, bradycardia, tachycardia, and arrhythmias, whereas its effects on the central nerve include dizziness, headache, euphoria, confusion, seizures, myoclonic clonic movements, opisthotonus, nausea, and vomiting [19][20][21][22].…”

Section: Discussionmentioning

confidence: 99%

Oxygen saturation profile in traumatic brain injury animal model after propofol administration

Kulsum,

Syahrul,

Hasbalah

et al. 2023

Narra J

View full text Add to dashboard Cite

Traumatic brain injury (TBI) is a traumatic that often leads to death due to untreatable cerebral hypoxia, indicated by oxygen saturation of <90%. Cerebral hypoxia is rarely monitored and thereby often overlooked as a cause of mortality and monitoring oxygen saturation is an accurate method to detect the condition. Propofol, an anesthetic agent, is commonly used in the management of TBI; however, its effect on brain tissue and cerebral hypoxia in TBI cases is not well understood. The aim of this study was to evaluate the profile of oxygen saturation in TBI animal model after propofol administration. A laboratory experimental study was conducted, involving 18 male Rattus novergicus rats (aged 4–8 weeks with weight between 150–200 grams) divided into three different treatment groups (non-TBI, TBI without propofol, and TBI with propofol). Oxygen saturation was measured regularly from day 1 to day 8 using pulse oximetry. The oxygen saturation percentages were compared between the TBI rats with and without propofol administration using independent Student t-rest. The results revealed significant reductions of oxygen saturation levels of animals within propofol-treated TBI group compared to that of the untreated-TBI group (p<0.05), with the average oxygen saturation ranging from 80.8%±6.96% vs 86.8%±5.48%. This finding suggests a reducing effect of propofol administration on oxygen saturation levels in rats with TBI and this potentially causes cerebral hypoxia.

show abstract

Section: Discussionmentioning

confidence: 99%

Oxygen saturation profile in traumatic brain injury animal model after propofol administration

Kulsum,

Syahrul,

Hasbalah

et al. 2023

Narra J

View full text Add to dashboard Cite

show abstract

“…analgesic effect makes more propofol is needed for expected anesthetic depth during the outpatient surgery or some short surgery. Furthermore, the combining medication induces dosagerelated ADRs of both drugs, for youngsters with frail circulatory and respiratory systems it could be important (30)(31)(32). Besides, children's poor oxygen reserves and high oxygen consumption also increase the risk of hypoxemia (5,33).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety comparison of esketamine-propofol with nalbuphine-propofol for upper gastrointestinal endoscopy in children: a multi-center randomized controlled trial

et al. 2023

View full text Add to dashboard Cite

Background and AimsAnesthetics such as propofol, esketamine and nalbuphine are used during the upper gastrointestinal endoscopy to achieve and maintain the desired sedation level. The aim of the study was to evaluate the effectiveness and safety of propofol-nalbuphine and propofol-esketamine in children.MethodsA multi-centered study was performed at three tertiary class-A hospitals. Children between 3 and 12 years old undergoing diagnostic painless upper gastrointestinal endoscopy were included and randomly divided into esketamine or nalbuphine group to estimate the primary outcome of successful endoscope insertion. The patients were given esketamine 0.5 mg/kg and propofol 2 mg/kg intravenously in esketamine group, with nalbuphine 0.2 mg/kg and propofol 2 mg/kg in the nalbuphine group. The primary outcome was success rate for the first attempt of endoscope insertion in each group. Secondary outcomes included the safety of both anesthesia regimens and gastroenterologist's satisfaction. We used the Face, Leg, Activity, Cry and Consolability (FLACC) scale to evaluate the level of pain before and during the procedure and the Pediatric Anesthesia Emergence Delirium (PAED) scale to assess the level of agitation and delirium after awakening from anesthesia.ResultsAmong 246 patients, 200 were randomly included in the final intention-to-treat analysis, with 100 patients in each group. The success rate for the first attempt of endoscope insertion in the esketamine group was higher than the nalbuphine group (97% vs. 66%; P < 0.01). The heart rate and mean arterial pressure after intraoperative administration in the esketamine group were higher than those in the nalbuphine group, while the delirium incidence during awakening was higher in esketamine group (all P < 0.05).ConclusionThe success rate for the first attempt of endoscope insertion of children undergoing upper gastrointestinal endoscopy in the esketamine group was higher than the nalbuphine group, propofol-related hemodynamic changes were reduced accordingly, while the incidence of esketamine-related adverse effects could be high.Clinical Trial RegistrationChinese Clinical Trial Registry: ChiCTR2000040500.

show abstract

“…10,12 Propofol as a single sedation drug for invasive or emergency procedures was effective at induction doses ranging from 0.5 to 1.5 mg/kg, associated with a mean maintenance dose of 100-250 mcg/kg/ min or 6-15 mg/kg/h in continuous infusion. [9][10][11]15,16 Main associated side effects include respiratory depression, hypoxemia, hypotension, laryngospasm and rare complaints of nausea and vomiting. 14,17,18 Dexmedetomidine proved to be favorable for pediatric sedation in a monotherapy regimen, considering its balanced hypnosis, similar to physiological sleep, and also its analgesic potential.…”

Section: Sedation For Invasive And/or Painful Proceduresmentioning

confidence: 99%

“…Azarfar, 2022 11 Yabrodi, 2022 17 Zhang, 2022 15 Guo, 2021 16 Homma, 2020 10 infusion: 100-250 mcg/kg/ min or 6-15 mg/kg/h…”

Section: Sedation For Imaging Examsmentioning

confidence: 99%

Pediatric sedation for emergency, imaging and endoscopic procedures: a worldwide review from the last five years

Monteiro Laranjeira,

Cardoso Andrade,

Souza Cordeiro

et al. 2024

JPNC

View full text Add to dashboard Cite

Introduction: Anatomical, physiological, pharmacokinetic, pharmaco dynamic and behavioral particularities relevant to the pediatric population make its sedation challenging for quick and low-complexity procedures. Robust evidence on this subject is still scarce, and the variety of drugs available, with their multiple routes of administration and dosage schemes, makes it difficult for providers to make a decision. Methods: Through research in four databases, we found 170 articles that addressed pediatric sedation and, after applying the exclusion criteria, we selected 32 articles for analysis. Results: In sedation for invasive or painful procedures, Esketamine in monotherapy was effective, despite the significant incidence of adverse effects. Satisfactory responses were also obtained with associations between Esketamine and Propofol and Fentanyl with Propofol or Midazolam. To perform imaging tests, continuous infusions of Propofol or Dexmedetomidine were sufficient, with associations with Esketamine or opioids associated with a higher incidence of adverse effects. Endoscopic procedures have been successfully performed after administration of continuous infusion of Propofol or Dexmedetomidine, associated with Remifentanil infusion or Fentanyl bolus. Esketamine in monotherapy was also effective. Discussion: The drugs studied have an adverse effect profile compatible with safe pediatric sedation, whether administered by a specialist or not. However, alternative administration routes and dosages still need further studies before being routinely applied. Conclusion: Sedation in pediatrics is still an open field for research in our country.

show abstract

Incidence of Adverse Effects of Propofol for Procedural Sedation/Anesthesia in the Pediatric Emergency Population: A Systematic Review and Meta-Analysis

Cited by 4 publications

References 40 publications

Oxygen saturation profile in traumatic brain injury animal model after propofol administration

Oxygen saturation profile in traumatic brain injury animal model after propofol administration

Efficacy and safety comparison of esketamine-propofol with nalbuphine-propofol for upper gastrointestinal endoscopy in children: a multi-center randomized controlled trial

Pediatric sedation for emergency, imaging and endoscopic procedures: a worldwide review from the last five years

Contact Info

Product

Resources

About