title: Clinical evaluation of propofol as sedative for endotracheal intubation in neonates.
abstract: OBJECTIVE
  To determine the effects of propofol for endotracheal intubation in neonates in daily clinical practice.
  
  
  METHODS
  We prospectively studied the pharmacodynamic effects of intravenous propofol administration in neonates who needed endotracheal intubation at the neonatal intensive care unit.
  
  
  RESULTS
  Propofol was used for 62 intubations in neonates with postmenstrual ages ranging from 24 + 3 weeks to 44 + 5 weeks and bodyweights ranging from 520 to 4380 g. A 2 mg/kg bodyweight propofol starting dose was sufficient in 37% of patients; additional propofol was needed less often on the first postnatal day. The mean amount of propofol used was 3.3 (±1.2) mg/kg. The success rate of intubation depended on the experience of the physician and was related to the total administered amount of propofol. Hypotension occurred in 39% of patients and occurred more often at the first postnatal day. In 15% of procedures, propofol mono therapy was insufficient.
  
  
  CONCLUSIONS
  This study shows that high doses of propofol are needed to reach effective sedation in neonates for intubation, with hypotension as a side effect in a considerable percentage of patients. Further research in newborn patients needs to identify optimal propofol doses and risk factors for hypotension.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: S H P
authors.initials: SH
authors.lastname: Simons
authors.forename: R
authors.initials: R
authors.lastname: van der Lee
authors.forename: Irwin K M
authors.initials: IK
authors.lastname: Reiss
authors.forename: M M
authors.initials: MM
authors.lastname: van Weissenbruch
mesh_terms: D018686:Anesthetics, Intravenous / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D007442:Intubation, Intratracheal; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies
chemical_list: D018686:Anesthetics, Intravenous; D015742:Propofol
keywords: Intubation; Neonatology; Propofol; Sedation