Propofol Infusion Dose Research Articles

Poster 1: outcomes of pediatric general anesthesia in an outpatient setting

Poster 1: outcomes of pediatric general anesthesia in an outpatient setting

Two propofol formulations are equivalent in small children aged 1 month to 3 years

Propofol has been widely used in general anesthesia. Although it is also often used in pediatric anesthesia, there has been only limited scientific evidence on the use of propofol in children up to 3 years. A prospective, randomized, double-blind, therapeutic equivalence study comparing two propofol 1% emulsions (Propofol 1% Fresenius vs. Diprivan 1%) was performed in 60 patients scheduled for routine surgery or for diagnostic laparoscopic procedures requiring anesthesia. To guarantee comparability of age distribution between the two groups, a stratified randomization with patients younger than 12 months of age in a low age group and with patients aged 12 months to 3 years in a high age group was used. The average propofol induction dose and the average propofol infusion dose were analyzed to prove equivalence. The side-effects profile was analyzed to compare the safety profiles of the two propofol formulations in this study. There were no differences in baseline characteristics between the two treatment groups of high and low age. Medications used for induction and maintenance of anesthesia, and side-effects profiles were comparable, as were the average propofol dose for induction of anesthesia (range of the mean dose 4.0-4.2 mg/kg) and for maintenance of anesthesia (range of the mean dose in the first hour 8.74-9.42 mg x kg(-1) x h(-1)). The two 1% propofol formulations were equally effective in our patient population of infants and young children between 1 month and 3 years of age. No differences between the two propofol formulations were found with regard to the circulatory reaction, lipid metabolism, dosages, and recovery profile in the studied age groups.

Is pancreatitis a complication of propofol infusion?

The effects of bolus and infusion doses of propofol on histopathological changes in the rat pancreas are reported. After obtaining Hospital Ethics Committee approval, 75 female Wistar rats were assigned to three study groups. Groups I (n = 30) and II (n = 30) received 10 mg kg-1 intravenous bolus of propofol; with propofol administered to group II at an infusion rate of 10 mg kg-1 h-1 for 30 min immediately after the bolus doses. Group III (n = 15) was used as the control group. Twenty-four hours after propofol administration blood samples and pancreatic tissue specimens were obtained under ether anaesthesia. Plasma cholesterol, triglyceride, amylase, and lipase levels were studied, and pancreatic tissues were examined under light microscopy. Plasma cholesterol and triglyceride levels were significantly higher in group II compared with the other groups. Differences between the groups in respect of plasma amylase and lipase levels were not statistically significant. Acute pancreatitis was observed under light microscopy, in three rats (10%) in group II, and in one rat (6.6%) in the control group. The pancreatic tissues of group I were normal. The incidence of acute pancreatitis in each of the groups was not significant. It is therefore suggested that, further controlled studies are needed to investigate the relation between pancreatitis and the use of propofol.