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| Title |
COMPARISON OF INTERMITTENT VERSUS CONTINUOUS
INFUSION OF PROPOFOL IN CHILDREN |
| Author |
S. Klein, G. Hauser, B. Anderson, A. Shad, J.
Gootenberg, H. Dalton, J. Hertzog. |
| Affiliation |
Divisions of Pediatric Critical Care and
Hematology/Oncology, Department of Pediatrics, Georgetown University, Washington, DC |
| Introduction |
Propofol is an IV anesthetic being used more
often in the PICU for short procedures. Propofol can be administered as bolus doses or as
a continuous infusion, but the two have not been compared. We prospectively compared
propofol as a continuous infusion versus bolus administration in children undergoing bone
marrow aspirations and/or lumbar punctures as an ambulatory procedure in the PICU. |
| Method |
After parental consent, children were divided by
procedure performed and randomly assigned to either continuous infusion or bolus
administration. Patients underwent medical evaluation, were NPO and had continuous vital
sign monitoring. Propofol was administered by a protocol. 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 < 5
were used as criteria for boluses. Values expressed as mean +/- SE and analyzed with
Student’s t test. |
| Result |
40 patients entered the study with 20 in each
group. No difference was present in subgroup analysis in the demographics, induction dose
and time, wake up time, total dose or adverse events. All patients had adequate anesthesia
and favorable satisfaction scores. More boluses were needed in the bolus group (8.5 +/- 1
v. 5 +/- 0.6, p<0.01) despite similar procedure lengths. MAP decreased in both groups
(28.7% +/- 3 v. 21.8 +/- 3, p>0.05). |
| Conclusion |
There was no clinically significant difference
between continuous or bolus. Close monitoring is mandatory considering the blood pressure
changes. Fewer interventions (i.e. boluses) are needed with continuous infusions, however
the preparation of the infusion pump can be tedious. Physician preference should dictate
which method is used. |
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