Continuous propofol infusion for the relief of treatment-resistant discomfort in a terminally ill pediatric patient with cancer.
OBJECTIVE
To determine the effectiveness of propofol as adjunctive therapy in the treatment of drug-resistant discomfort in a terminally ill pediatric patient.


METHODS
A 3-year-old child with advanced rhabdomyosarcoma and severe drug-resistant discomfort was studied. Propofol was administered as adjunctive therapy to provide relief from severe discomfort.


RESULTS
Propofol was initiated with a loading dose of 1.2 mg/kg followed by a continuous intravenous infusion of 1.2 mg/kg/h. Over the next 10 days, additional loading doses were administered and the infusion rate was increased to a maximum of 32 mg/kg/h. After the addition of propofol, our patient's discomfort improved greatly without the occurrence of propofol-associated adverse events.


CONCLUSIONS
Propofol appears to be an effective adjunct to opioids and a promising alternative to barbiturate therapy in the treatment of drug-resistant discomfort in terminally ill pediatric patients.
Rainbow Babies and Childrens Hospital, Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
M L
ML
Glover
E
E
Kodish
M D
MD
Reed
D000008:Abdominal Neoplasms / Q000188:drug therapy; D002675:Child, Preschool; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D010166:Palliative Care / Q000379:methods*; D015742:Propofol / Q000008:administration & dosage*; D012208:Rhabdomyosarcoma / Q000188:drug therapy; D013727:Terminal Care / Q000379:methods*
D015742:Propofol