Propofol anesthesia in spontaneously breathing children undergoing magnetic resonance imaging: comparison of two propofol emulsions.
BACKGROUND
This study evaluated a propofol-based anesthesia regimen with spontaneous breathing in pediatric patients scheduled for magnetic resonance imaging (MRI).


METHODS
In this prospective, randomized, double-blind study propofol formulated with long-chain triglycerides (LCT) and mixed medium-chain/long-chain triglycerides (MCT/LCT) were used. Ninety patients aged 2.4 months to 7.3 years were premedicated with intravenous midazolam. Lidocaine was injected prior to propofol to reduce injection pain. Anesthesia was induced and maintained by propofol. Glycopyrronium bromide was administered for saliva reduction. Hemodynamics, blood oxygen saturation and endtidal capnography were continuously monitored. All patients received additional oxygen. The aggregated propofol dose for induction and maintenance of anesthesia was analyzed for therapeutic equivalence. Incidence of injection pain, laboratory safety values, vital signs, and the adverse event profile were analyzed to compare tolerability and safety.


RESULTS
Propofol anesthesia was safe and successful in all children. Both propofol formulations were equivalent regarding dose requirements (mean induction and maintenance doses for anesthesia 2.0-4.0 mg.kg(-1) and 6.0-8.8 mg.kg(-1).h(-1) respectively; aggregated doses 8-13.26 mg.kg(-1)). There were no differences in drug safety such as hemodynamics, spontaneous breathing, injection pain, and laboratory values. Duration of induction and of recovery from anesthesia were short and all examinations were completed with minimal interruption.


CONCLUSIONS
Propofol-based short-term anesthesia was well suited for anesthesia during MRI procedures in the studied pediatric patients. There were no clinically relevant differences between the two propofol formulations.
Department of Anaesthesiology and Intensive Care Medicine, Medical University Graz, Graz, Austria. anton.gutmann@meduni-graz.at
Anton
A
Gutmann
Klaus
K
Pessenbacher
Andrea
A
Gschanes
Udo
U
Eggenreich
Manfred
M
Wargenau
Wolfgang
W
Toller
D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004304:Dosage Forms; D004311:Double-Blind Method; D004655:Emulsions; D005260:Female; D006801:Humans; D007223:Infant; D007275:Injections, Intravenous; D008279:Magnetic Resonance Imaging; D008297:Male; D015742:Propofol / Q000009:adverse effects; D013810:Therapeutic Equivalency; D014280:Triglycerides
D018686:Anesthetics, Intravenous; D004304:Dosage Forms; D004655:Emulsions; D014280:Triglycerides; D015742:Propofol