The Safe and Effective Use of Propofol Sedation in Children Undergoing Diagnostic and Therapeutic Procedures: Experience in a Pediatric ICU and a Review of the Literature

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ObjectivesTo describe our experience using propofol sedation to facilitate elective diagnostic and therapeutic procedures, and to document the safety profile of propofol in this setting.DesignRetrospective consecutive case series and review of the literature.SettingPediatric intensive care unit of a United States Navy tertiary care medical center.PatientsChildren receiving propofol for procedural sedation over an 18-month period.Outcome MeasuresDescriptive features of sedation including adverse events.ResultsDuring the study period, 91 children received propofol to facilitate the performance of 110 medical procedures. The mean induction dose was 2.41 mg/kg, the mean infusion rate was 179.3 μg/kg/min, and the mean total dose of propofol administered was 4.23 mg/kg. In all cases, sedation was successfully achieved. The average length of stay in the PICU was 108.4 minutes. Three children (3.3%) had transient episodes of oxygen desaturation that improved with repositioning of the airway. No child required placement of an endotracheal tube. Three (3.3%) children experienced hypotension requiring a decrease in the infusion rate of propofol and a 10-mL/kg bolus infusion of normal saline. No cardiac arrhythmias or adverse neurologic effects secondary to propofol infusion were identified.ConclusionsPediatric intensivists can safely and effectively administer propofol to facilitate the performance of diagnostic and therapeutic procedures outside the operating room setting.

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