A national survey of propofol infusion use by paediatric anaesthetists in Great Britain and Ireland

Abstract

Since the introduction of propofol in 1977, it has been widely used for the induction and maintenance of anaesthesia and for sedation on the intensive care unit. Recently, case reports of suspected propofol infusion syndrome (PRIS) following short term infusions have been published. We set out to obtain a picture of the current use of propofol infusions by paediatric anaesthetists in Great Britain and Ireland. A questionnaire concerning the use of propofol infusions was sent to 388 paediatric anaesthetists. A total of 242 (62%) replies were received. 26% of anaesthetists used propofol infusions with at least a monthly frequency. 136 (56%) anaesthetists thought that propofol infusions were of benefit in reducing postoperative nausea and vomiting. The majority of anaesthetists did not state a maximum infusion rate or length of infusion. Of those anaesthetists who answered the questions the maximum rate used was 30 mg x kg(-1) x h(-1) and the longest time considered for an infusion was 72 h. Only 5 (2%) anaesthetists regularly used BIS monitoring, although 106 (44%) expressed a desire to use it if it was freely available in their hospitals. Modifications to infusions from 1% to 2% propofol were used by 38 (16%) anaesthetists and 28 (12%) used glucose infusions intra-operatively. There is a wide variety in the use of propofol infusions by paediatric anaesthetists. The mechanisms underlying PRIS are poorly understood and require further work to ensure propofol infusions are used appropriately for anaesthesia in children.