The evaluation of propofol dosage for anesthesia induction in children with cerebral palsy with bispectral index (BIS) monitoring.
BACKGROUND
We designed a randomized prospective study to investigate whether developmentally delayed children with cerebral palsy (CP) need a lower dosage of propofol for induction than normal children using bispectral index (BIS) monitoring criteria.


METHODS
After approval by the University Ethical Committee and written informed consent obtained from parents, 20 children with noncommunicative/nonverbal CP and 20 normal children requiring general anesthesia for elective orthopedic surgery were enrolled in the study. The patients were not premedicated. BIS leads were placed before the induction of anesthesia. Propofol was administered at a rate of 20 mg.30 s(-1) (i.e. 40 mg.min(-1)). When BIS value had reached a steady number of 35-45, infusion was stopped.


RESULTS
There was no significant difference between Group N and Group CP in age and sex distribution (P > 0.05), however children in Group CP weighed less than Group N (P = 0.05). The propofol dosage for induction was significantly lower in Group CP than Group N (P = 0.03). There were no differences in propofol doses administered to children using anticonvulsants and those not on anticonvulsants in Group CP. BIS values were comparable between the two groups (i.e. Group N and Group CP) at baseline and after propofol administration.


CONCLUSIONS
Our data suggest that noncommunicative/nonverbal children with CP require less propofol to obtain the same BIS values (i.e. 35-45) than do otherwise healthy children.
Saricaoglu
F
F
Department of Anaesthesiology and Reanimation, Hacettepe University, Ankara, Turkey. fatmasaricao@yahoo.com
Celebi
N
N
Celik
M
M
Aypar
U
U
D000768:Anesthesia, General; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D002547:Cerebral Palsy / Q000150:complications; D002648:Child; D003147:Communication Disorders / Q000150:complications; D002658:Developmental Disabilities / Q000150:complications; D004569:Electroencephalography; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy; D006801:Humans; D016343:Monitoring, Intraoperative; D015742:Propofol / Q000008:administration & dosage*
D018686:Anesthetics, Intravenous; D015742:Propofol