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The use of propofol infusions in paediatric anaesthesia: a practical guide
Author(s) -
McFarlan Charles S.,
Anderson Brian J.,
Short Timothy G.
Publication year - 1999
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1046/j.1460-9592.1999.00364.x
Subject(s) - medicine , propofol , context (archaeology) , pharmacokinetics , anesthesia , regimen , loading dose , steady state (chemistry) , surgery , pharmacology , paleontology , chemistry , biology
Summary Children require higher infusion rates of propofol than adults to maintain clinical anaesthesia. We aimed to produce a manual infusion regimen capable of maintaining a steady‐state blood concentration of 3 μg ml −1 in children aged 3–11 years. Pharmacokinetic parameter estimates were taken from published studies of infusion data in children and used in a pharmacokinetic simulation programme to predict likely propofol blood concentrations during infusions. A variability of 5% was allowed about the target concentration of 3 μg ml −1 . A loading dose of 2.5 mg·kg −1 followed by an infusion rate of 15 mg·kg −1 ·h −1 for the first 15 min, 13 mg·kg −1 ·h −1 from 15 to 30 min, 11 mg·kg −1 ·h −1 from 30 to 60 min, 10 mg·kg −1 ·h −1 from 1 to 2 h and 9 mg·kg −1 ·h −1 from 2 to 4 h resulted in a pseudo‐steady state target concentration of 3 μg·ml −1 in children 3–11 years. We were unable to predict similar rates by applying size models to adult data. The context sensitive half‐time in children was longer than in adults, rising from 10.4 min at 1 h to 19.6 min at 4 h compared to adult estimates of 6.7 min and 9.5 min, respectively. Children require higher infusion rates than adults to maintain steady state concentrations of 3 μg·ml −1 and have longer context sensitive half‐times than adults. These differences can be attributed to altered pharmacokinetics in this age group.