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Sedation with propofol for flexible bronchoscopy in children
Author(s) -
Hasan Rashed A.,
Reddy Ramalinga
Publication year - 2009
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.21013
Subject(s) - medicine , propofol , sedation , bronchoscopy , demographics , anesthesia , diastole , pediatrics , surgery , blood pressure , demography , sociology
Background The purpose of this study was to report our experience with intravenous propofol (IVP) sedation for flexible bronchoscopy (FB) in children. Methods The following data were collected: demographics, pre‐ and post‐procedure diagnoses, induction time (IT), sedation time (ST), procedure time (PT), time to discharge from the hospital (TTD), induction dose (ID) of IVP, total dose (TD) of IVP, and complications. HR, RR, systolic BP (SBP), diastolic BP (DBP), and SpO 2 were recorded every 5 min. Results One hundred three (66 males, 37 females) consecutive patients (age: 4.7 ± 4.3 years) and (weight: 21.2 ± 16 kg) were enrolled over a 3‐year‐period. Airway Abnormalities were diagnosed in 93 (90%) patients leading to a change in therapy in 68 (66%) patients. In 20 (19.4%) patients abnormalities unrelated to the primary indication for FB were found. IT was 4.64 ± 2 min, PT was 6.2 ± 3.1 min, ST was 27 ± 14 min, and TTD was 80 ± 44 min. The ID and TD for IVP were 2.8 ± 0.1 mg/kg, and 3.1 ± 0.1 mg/kg respectively. Patients 4–7 years of age required higher induction doses (IDs) of propofol (3.5 ± 1 mg/kg) compared to infants (2.8 ± 0.9 mg/kg), 1–3 years of age (2.7 ± 0.78 mg/kg) and 8–17 years of age (2.4 ± 0.7 mg/kg) ( P < 0.001). There was a correlation between the TD of IVP and TTD from the hospital (r = 0.5, P < 0.01). The drop in SBP (104 ± 15 vs. 92 ± 13 mm Hg, P < 0.05) and DBP (57 ± 13 vs. 46 ± 9 mm Hg, P < 0.05) during IVP were statistically significant compared to baseline, however none of the patients met the criteria for hypotension. Two patients developed short (<20 sec) respiratory pauses without hypoxia. No patient required fluid resuscitation or endotracheal intubation. Conclusions FB may be performed successfully in children using IVP and is associated with insignificant cardio‐respiratory complications. Pediatr Pulmonol. 2009; 44:373–378. © 2009 Wiley‐Liss, Inc.