Comparison of intermittent versus continuous infusion of propofol for elective oncology procedures in children
| Autor: | Joseph E. Gootenberg, Aziza T. Shad, Heidi J. Dalton, Gabriel J. Hauser, Barry D Anderson, Scott M. Klein, James H. Hertzog |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male Adolescent Antineoplastic Agents Critical Care and Intensive Care Medicine Intensive Care Units Pediatric Spinal Puncture law.invention Bolus (medicine) Catheters Indwelling Randomized controlled trial law Neoplasms Ambulatory Care Medicine Humans Dosing Prospective Studies Adverse effect Child Infusions Intravenous Propofol Pediatric intensive care unit business.industry Biopsy Needle Infant Blood pressure Treatment Outcome Anesthesia Child Preschool Pediatrics Perinatology and Child Health Ambulatory Injections Intravenous Anesthesia Intravenous Female business Anesthetics Intravenous medicine.drug |
| Zdroj: | Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies. 4(1) |
| ISSN: | 1529-7535 |
| Popis: | OBJECTIVE To compare the effects of administering propofol as a continuous infusion vs. bolus dosing in children undergoing ambulatory oncologic procedures in the pediatric intensive care unit (PICU). DESIGN Prospective, randomized study. SETTING Tertiary PICU in a university hospital. PATIENTS Ambulatory oncology patients scheduled for diagnostic or therapeutic procedures with propofol anesthesia in the PICU were eligible for enrollment. INTERVENTIONS Patients were randomly assigned to receive either continuous infusion or bolus administration of propofol in a protocol-driven manner. All patients received an initial bolus of 1.5 mg/kg, with additional 0.5 mg/kg doses until complete induction. Continuous infusions were started at 0.1 mg/kg/min and, if needed, increased 20% after a bolus of 0.5 mg/kg. Bolus group patients were given doses of 0.5 mg/kg if needed. Ramsay scores of < 5 were used as criteria for additional dosing. MEASUREMENTS AND MAIN RESULTS Eighteen patients undergoing 40 separate procedures were enrolled during the study period. Twenty procedures each were performed with continuous or bolus administration of propofol. No differences were present between groups in demographic characteristics, induction dose and time, procedure and recovery times, or adverse events. All patients had adequate anesthesia and favorable satisfaction scores. More boluses were needed in the bolus group (8.5 +/- 4.6 vs. 5.4 +/- 2.9; p < .05). Average systolic blood pressure decreased more in the continuous infusion group (26.4% +/- 12 vs. 19.3% +/- 10; p < .05). Total propofol dose was higher in the continuous infusion group (8.0 mg/kg +/- 3.8 vs. 5.7 mg/kg +/- 2.4; p < .05). CONCLUSION Both continuous and bolus administration of propofol provided conditions for conducting oncologic procedures that were satisfying to patients, their families, and physicians. Continuous infusions were associated with a larger total dose and greater decreases in systolic blood pressure. Physician preference is likely to dictate which method is used. |
| Databáze: | OpenAIRE |
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