title: Is propofol a safe alternative to pentobarbital for sedation during pediatric diagnostic CT?
abstract: OBJECTIVE
  To prospectively compare the incidence of adverse respiratory events, the need for airway interventions, and the recovery time after propofol sedation with similar data from a retrospective review of data obtained in patients who underwent pentobarbital sedation.
  
  
  METHODS
  This HIPAA-compliant study was conducted with institutional review board approval and parental informed consent. The hospital sedation committee approved a 2-month pilot program of propofol sedation as a potential alternative to pentobarbital sedation. Parents were given the choice of having their child sedated with intravenously administered propofol or pentobarbital. Fifty-two patients (18 female, 34 male; mean age, 2.9 years +/- 2.4 [standard deviation]) received propofol. An equal number of patients (21 female, 31 male; mean age, 2.5 years +/- 1.7) who previously received pentobarbital were included. The sample sizes provided 80% power to detect differences in airway manipulations, adverse respiratory events, and recovery time between the groups by using the Fisher exact test and the Student t test. A two-tailed P value of less than .05 indicated a significant difference.
  
  
  RESULTS
  Patients sedated with propofol underwent significantly more airway manipulations to relieve obstruction than did patients sedated with pentobarbital (23% vs 0%, P < .001). More adverse respiratory events occurred in the propofol group than in the pentobarbital group (12% vs 0%, P = .03). Patients in the propofol group had a faster recovery profile than did patients in the pentobarbital group (34 minutes +/- 17 vs 100 minutes +/- 30, P < .001).
  
  
  CONCLUSIONS
  Propofol is associated with a significantly greater incidence of adverse respiratory events than is pentobarbital.
authors.affiliation: Department of Anesthesia, Children's Hospital Boston, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, USA. steven.zgleszewski@childrens.harvard.edu
authors.forename: Steven E
authors.initials: SE
authors.lastname: Zgleszewski
authors.forename: David
authors.initials: D
authors.lastname: Zurakowski
authors.forename: Paulette J
authors.initials: PJ
authors.lastname: Fontaine
authors.forename: Margaret
authors.initials: M
authors.lastname: D'Angelo
authors.forename: Keira P
authors.initials: KP
authors.lastname: Mason
mesh_terms: D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D016014:Linear Models; D008297:Male; D010424:Pentobarbital / Q000008:administration & dosage* / Q000009:adverse effects; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed
chemical_list: D006993:Hypnotics and Sedatives; D010424:Pentobarbital; D015742:Propofol