Abstract
BackgroundWe investigated the impact of the type of neurological disorder on the required propofol dose for anesthesia and the time to emerge from anesthesia during dental treatment in patients with autism (AU), cerebral palsy (CP), and intellectual disability (ID), some of whom also had epilepsy.MethodsWe studied 224 patients with a neurological disorder who underwent dental treatment under intravenous general anesthesia. Patients were categorized according to neurological disorder (AU, CP, and ID; and with or without an antiepileptic). The propofol dose required for anesthesia, time to emerge, and modeled propofol blood concentration at emergence were evaluated.ResultsIn patients not given an antiepileptic, we found no significant differences in the propofol dose, modeled propofol blood concentration at emergence, or time to emerge among patients with AU, CP, and ID (P > 0.05). When using an antiepileptic, the dose of propofol (5.7 ± 1.51 mg/kg/h) was significantly lower than without an antiepileptic (6.8 ± 1.27 mg/kg/h) (P < 0.0001). The modeled propofol blood concentration at emergence in patients given an antiepileptic (0.5 ± 0.03 μg/ml) was significantly lower than without an antiepileptic (0.7 ± 0.02 μg/ml) (P < 0.0001). The time to emerge in patients given an antiepileptic (29.5 ± 12.5 min) was significantly longer than without an antiepileptic (21.6 min ± 10.0 min) (P < 0.0001).ConclusionThe propofol dose required for anesthesia and the time to emerge from anesthesia are not affected by the type of neurological disorder, but are affected by antiepileptic use.Trial registrationUniversity Hospital Medical Information Network Clinical Trials Registry (UMIN000014179), Date of registration 4 June 2014.
Highlights
We investigated the impact of the type of neurological disorder on the required propofol dose for anesthesia and the time to emerge from anesthesia during dental treatment in patients with autism (AU), cerebral palsy (CP), and intellectual disability (ID), some of whom had epilepsy
The objective of the present study was to investigate the relationship between the type of neurological disorder and the propofol dose required for anesthesia and the time to emerge from anesthesia during dental treatment in patients with autism, cerebral palsy, and intellectual disability
As a post-test, in patients not given an antiepileptic, we found no significant differences in the dose of propofol administered, modeled propofol blood concentration at emergence (AU: 0.7 ± 0.19 μg/ml; CP: 0.7 ± 0.21 μg/ml; ID: 0.8 ± 0.26 μg/ml; P = 0.24), or time to emerge from anesthesia (AU: 22.1 ± 9.33 min; CP: 21.1 ± 8.90 min; ID: 21.3 ± 10.73 min; P = 0.90) among patients with AU (n = 59), CP (n = 8), and ID (n = 80) (Table 4)
Summary
We investigated the impact of the type of neurological disorder on the required propofol dose for anesthesia and the time to emerge from anesthesia during dental treatment in patients with autism (AU), cerebral palsy (CP), and intellectual disability (ID), some of whom had epilepsy. The objective of the present study was to investigate the relationship between the type of neurological disorder and the propofol dose required for anesthesia and the time to emerge from anesthesia during dental treatment in patients with autism, cerebral palsy, and intellectual disability.
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