The safe and effective use of propofol sedation in children undergoing diagnostic and therapeutic procedures: experience in a pediatric ICU and a review of the literature.
OBJECTIVE
To describe our experience using propofol sedation to facilitate elective diagnostic and therapeutic procedures, and to document the safety profile of propofol in this setting.


METHODS
Retrospective consecutive case series and review of the literature.


METHODS
Pediatric intensive care unit of a United States Navy tertiary care medical center.


METHODS
Children receiving propofol for procedural sedation over an 18-month period.


METHODS
Descriptive features of sedation including adverse events.


RESULTS
During the study period, 91 children received propofol to facilitate the performance of 110 medical procedures. The mean induction dose was 2.41 mg/kg, the mean infusion rate was 179.3 microg/kg/min, and the mean total dose of propofol administered was 4.23 mg/kg. In all cases, sedation was successfully achieved. The average length of stay in the PICU was 108.4 minutes. Three children (3.3%) had transient episodes of oxygen desaturation that improved with repositioning of the airway. No child required placement of an endotracheal tube. Three (3.3%) children experienced hypotension requiring a decrease in the infusion rate of propofol and a 10-mL/kg bolus infusion of normal saline. No cardiac arrhythmias or adverse neurologic effects secondary to propofol infusion were identified.


CONCLUSIONS
Pediatric intensivists can safely and effectively administer propofol to facilitate the performance of diagnostic and therapeutic procedures outside the operating room setting.
Wheeler
Derek S
DS
Department of Pediatrics, Naval Medical Center, San Diego, CA, USA. dewheeler@mcg.edu
Vaux
Keith K
KK
Ponaman
Michael L
ML
Poss
Bradley W
BW
D002648:Child; D003933:Diagnosis; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use*; D007022:Hypotension / Q000139:chemically induced; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D015742:Propofol / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D012449:Safety; D013812:Therapeutics
D006993:Hypnotics and Sedatives; D015742:Propofol