Sedation With Propofol in the Picu

Paschall, Alan; Braner, Dana

doi:10.1097/00003246-199304001-00050

Cited by 4 publications

(7 citation statements)

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“…These effects are consistent with previous studies on the use of propofol in children outside the operating room (33,34). Children tend to recover from propofol sedation without emergence phenomena, residual drowsiness, confusion, or agitation.…”

Section: Discussionsupporting

confidence: 93%

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Deep sedation with propofol for children undergoing ambulatory magnetic resonance imaging of the brain: Experience from a pediatric intensive care unit

Hasan

Shayevitz

Patel

2003

Pediatric Critical Care Medicine

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Section: Discussionsupporting

confidence: 93%

“…Children tend to recover from propofol sedation without emergence phenomena, residual drowsiness, confusion, or agitation. As a result, they tend to be discharged home sooner (33,34). This rapidity of recovery is likely to be associated with less resource utilization for postsedation monitoring.…”

Section: Discussionmentioning

confidence: 99%

Deep sedation with propofol for children undergoing ambulatory magnetic resonance imaging of the brain: Experience from a pediatric intensive care unit

Hasan

Shayevitz

Patel

2003

Pediatric Critical Care Medicine

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“…The times noted in our study are somewhat longer then those reported in other studies, 21,22 which may be attributable to the difficulty in establishing exact times of induction and recovery in a retrospective review, our practice of keeping the patient still during the procedure by maintaining deep levels of anesthesia, and our practice of not actively attempting to wake up the patient after the completion of the procedure. The only difference found between patient groups is that ward patients had a shorter time from admission to the start of anesthesia than did ambulatory patients.…”

Section: Discussioncontrasting

confidence: 56%

“…8 A review of 105 procedures using propofol anesthesia in a PICU demonstrated awakening times of 12 to 22 minutes, transient oxygen desaturations in 7 patients, a fall in systolic blood pressure of Ն20% in 20 patients, and myoclonic movements in 5 patients. 21 In a report of 124 outpatient procedures performed in 96 children in the PICU, 8 children had obstructive apnea requiring airway positioning, 3 children required bagvalve-mask ventilation, 3 children had a transient decrease in systolic blood pressure to Ͻ60 torr, and 3 children had myoclonic movements. 22 In our review of 251 invasive procedures in ambulatory and hospitalized children, we found that propofol anesthesia was highly effective and safely administered in the PICU setting.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 1999

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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...

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“…There were 22 reported incidences of myoclonus giving an overall incidence of 0.13%. Four studies had between two and five patients that demonstrated some myoclonic movements of limbs during propofol sedation all of which resolved spontaneously without treatment or on inducing a deeper level of sedation 16,21,24,27,39 . Hertzog et al .…”

Section: Discussionmentioning

confidence: 99%

Review article: Safety profile of propofol for paediatric procedural sedation in the emergency department

Lamond

2010

Emerg Medicine Australasia

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The use of propofol for paediatric procedural sedation (PPS) is increasing because of its favourable pharmacodynamic profile. Its paediatric use has been limited in some ED (emergency departments) because of the perceived high rate of serious adverse events in comparison with other sedation agents. A systematic literature review of propofol use for PPS outside the operating theatre environment from 1966 to 2008 was carried out to profile the adverse event rate in comparison with other procedural sedation agents. Sixty studies with a total of 17,066 paediatric propofol sedations in a variety of hospital settings were identified. The incidence of complications were: desaturation 9.3%, apnoea 1.9%, assisted ventilation 1.4%, hypotension 15.4%, unplanned intubation 0.02%, emesis post procedure 0.14%, laryngospasm 0.1% and bradycardia 0.1%. There were no reported incidents of aspiration or emesis during sedation and there were no deaths associated with procedural propofol sedation. The use of propofol for PPS is associated with a low rate of minor adverse events that are all reversible with minimal intervention and do not produce long-term sequelae and occur at similar rates to minor adverse events experienced with other sedation agents. Major adverse events with propofol sedation are extremely rare and appropriate patient and procedure selection would decrease these risks further. The increasing use of propofol for ED PPS is supported by the current evidence because of its comparable adverse event rate to other agents.

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Sedation With Propofol in the Picu

Cited by 4 publications

References 0 publications

Deep sedation with propofol for children undergoing ambulatory magnetic resonance imaging of the brain: Experience from a pediatric intensive care unit

Deep sedation with propofol for children undergoing ambulatory magnetic resonance imaging of the brain: Experience from a pediatric intensive care unit

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

Review article: Safety profile of propofol for paediatric procedural sedation in the emergency department

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