Abstract
Background To investigate the incidence of adverse effects of propofol among pediatric population for sedation or anesthesia. Methods We performed Cochrane Library, PubMed, CNKI, VIP, and Wanfang databases to research relevant literature. We did sensitivity analysis to assess the incidence of adverse effects of propofol among pediatric population for sedation or anesthesia. Results In 132 studies, eight RCTs were included in this analysis. The result showed that adverse events (bradypnea, hypotension, hypertension, and apnea) were significantly improved in the pediatric emergency population in the propofol group, but it had no effect on the incidence of cough attacks, desaturation, agitation, stridor, and laryngospasm. Furthermore, the subgroup analysis showed that those who received propofol for had decreased adverse effects compared with the patients who received ketamine treatment (SMD = 0.44, 95%CI = [0.28, 0.67], I2 = 0%, and P = 0.0002), which demonstrated that propofol could decrease the incidence of adverse effects compared with ketamine and ketofol. Conclusions The study demonstrated that propofol may decrease the incidence of bradypnea, hypotension, hypertension, and apnea, but it had no effect on the incidence of cough attacks, desaturation, agitation, stridor, and laryngospasm. Furthermore, more large RCTs are needed to assess incidence of adverse effects of propofol among pediatric population.
Highlights
Pediatric emergency treatment is often accompanied by trauma or pain
The results demonstrated that those who received propofol for had decreased adverse effects compared with the patients who received ketamine treatment (SMD = 0:44, 95%CI = 1⁄20:28, 0:67, I2 = 0%, and P = 0:0002)
The combined results showed that compared with other sedative drugs, propofol had decreased the incidence of bradypnea, hypotension, hypertension, and apnea, but it had no effect on the incidence of cough attacks, desaturation, agitation, stridor, and laryngospasm
Summary
Pediatric emergency treatment is often accompanied by trauma or pain. Some painful or uncomfortable procedures may be necessary during emergency treatment, and emergency physicians are needed to provide safe and effective analgesia and sedation for children [1, 2]. The poor effect of pediatric procedural sedation/anesthesia in the emergency department is due to the side effects and adverse reactions of drugs are not clear to clinicians [11, 12].Propofol is a sedative-hypnotic agent widely used for procedural sedation [13]. We did sensitivity analysis to assess the incidence of adverse effects of propofol among pediatric population for sedation or anesthesia. The result showed that adverse events (bradypnea, hypotension, hypertension, and apnea) were significantly improved in the pediatric emergency population in the propofol group, but it had no effect on the incidence of cough attacks, desaturation, agitation, stridor, and laryngospasm. More large RCTs are needed to assess incidence of adverse effects of propofol among pediatric population
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