title: [Safety and efficacy of continuous infusion propofol for diagnostic upper gastrointestinal endscopy in spontaneous breathing].
abstract: BACKGROUND
  Invasive procedures (IP) are an important reason for admision to PICU. Paediatric patients need a special anaesthetic approach and deep sedation is frequently required. The objective was to evaluate the safety and efficacy of continuous infusion propofol to achieve sedation for diagnostic upper gastrointestinal endoscopy (UGE) in spontaneous breathing.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Secondary hospital Paediatric Intensive Care Unit. Period of study September 2009 to May 2010.
  
  
  METHODS
  Children subjected to diagnostic UGE.
  
  
  METHODS
  sedation-analgesia protocol with: fentanyl (1 ug/kg for first dose and 0.5 ug/kg for the next one), propofol (1-2 mg/kg for first dose and continuous infusion at 3-4 mg/kg/h, if needed, subsequent doses at 0.5-1 mg/kg and increasing infusion from 1 mg/kg/h up to 6 mg/kg/h maximum). The objective was to reach 5-6 grade for modified Ramsay scale and amnesia related to UGE. Main endpoints: a) dose of drugs, b) time to sedoanalgesia, recovery and length for the procedure, c) sedoanalgesis grade and amnesia related to procedure and d) adverse effects.
  
  
  RESULTS
  Expressed as median and interquartile range; 31 sedoanalgesias were performed on 31 children for UGE. Indications for UGE were suspected coeliac disease (84%) or dyspeptic syndrome (16%). Mean age was 8 (2-11) years. Propofol total dose 5 (3.8-6.2) mg/kg. Propofol infusion rate 4 (3.8-4.5) mg/kg/h. Fentanyl dose 1 (1-1) μg/kg. Induction time 6 (5-9) minutes, procedural time 15 (10-25) minutes and recovery/awake time 10 (9-14) minutes. Adverse effects observed consisted of 1 patient vomiting. UGE was successfully achieved in 100%. Amnesia was achieved in all of the 21 patients older than 4 years.
  
  
  CONCLUSIONS
  Continuous propofol infusion seems to be both effective and safe to achieve sedation for diagnostic upper gastrointestinal endoscopy in spontaneously breathing.
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, UGC Pediatría, Hospital Materno-Infantil de Jaén, España. fjaladosarbol@ono.com
authors.forename: F J
authors.initials: FJ
authors.lastname: Alados-Arboledas
authors.forename: P
authors.initials: P
authors.lastname: Millán-Bueno
authors.forename: J F
authors.initials: JF
authors.lastname: Expósito-Montes
authors.forename: J
authors.initials: J
authors.lastname: de la Cruz-Moreno
authors.forename: A
authors.initials: A
authors.lastname: Pérez-Parras
authors.forename: A
authors.initials: A
authors.lastname: Arévalo-Garrido
mesh_terms: D002648:Child; D002675:Child, Preschool; D054810:Deep Sedation; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D007262:Infusions, Intravenous; D008297:Male; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D012119:Respiration
chemical_list: D006993:Hypnotics and Sedatives; D015742:Propofol