Pediatric procedural sedation by a dedicated nonanesthesiology pediatric sedation service using propofol.
OBJECTIVE
To evaluate the success and dosing requirements of propofol in children for prolonged procedural sedation by a nonanesthesiology-based sedation service.


METHODS
The pediatric sedation service at this institution uses propofol as its preferred sedative, and the local guideline suggests using 3 mg/kg for induction and 5 mg kg(-1) h(-1) for maintenance sedation. Doses can be adjusted as needed to individualize successful sedation. A retrospective analysis of patients sedated for 30 minutes or longer was conducted. Patients were stratified into 4 cohorts based on age (<1 year [n = 16], 1-2 years [n = 85], 3-7 years [n = 54], and >7 years [n = 55]) and dosing patterns, success, and adverse effects were investigated.


RESULTS
Two hundred forty-nine patients met the inclusion criteria. Mean age was 4.8 years (SD, 4.1). The mean induction dose was 3.2 mg/kg (range, 0.9-9.7), and the mean maintenance infusion was 5.2 mg kg(-1) h(-1) (range, 0.14-21.3). No differences were seen in the induction doses in the different age cohorts, yet the SD was largest in the youngest cohort compared to any other. Although no differences were seen in maintenance rates by age, the greatest SD for dosing was seen in the oldest cohort. For all ages, all sedations were successful (100%) and unanticipated adverse effects rare (<1%).


CONCLUSIONS
Although it seems that the mean dosing of propofol does not vary significantly with age, there is greater variability in induction dosage for those younger than 1 year and in maintenance dosing for those 7 years or older. The results and general dosing parameters may assist pediatric subspecialists in using propofol for prolonged procedural sedation.
Patel
Kalpesh N
KN
Division of Pediatric Emergency Medicine, Department of Pediatrics, Emory Transplant Center, Emory University School of Medicine, USA.
Simon
Harold K
HK
Stockwell
Christina A
CA
Stockwell
Jana A
JA
DeGuzman
Michael A
MA
Roerig
Pei-Ling
PL
Rigby
Mark R
MR
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D054810:Deep Sedation / Q000379:methods*; D019937:Diagnostic Techniques and Procedures; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007223:Infant; D007231:Infant, Newborn; D007275:Injections, Intravenous; D008297:Male; D010372:Pediatrics / Q000379:methods*; D015742:Propofol / Q000008:administration & dosage*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
D006993:Hypnotics and Sedatives; D015742:Propofol