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Propofol in neonates causes a dose‐dependent profound and protracted decrease in blood pressure
Author(s) -
Kort Ellen H. M.,
Twisk Jos W. R.,
t Verlaat Ellen P. G.,
Reiss Irwin K. M.,
Simons Sinno H. P.,
Weissenbruch Mirjam M.
Publication year - 2020
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.15282
Subject(s) - propofol , medicine , anesthesia , blood pressure , dosing , premedication , sedative , intubation , pharmacology
Aim To analyse the effects of different propofol starting doses as premedication for endotracheal intubation on blood pressure in neonates. Methods Neonates who received propofol starting doses of 1.0 mg/kg (n = 30), 1.5 mg/kg (n = 23) or 2.0 mg/kg (n = 26) as part of a previously published dose‐finding study were included in this analysis. Blood pressure in the 3 dosing groups was analysed in the first 60 minutes after start of propofol. Results Blood pressure declined after the start of propofol in all 3 dosing groups and was not restored 60 minutes after the start of propofol. The decline in blood pressure was highest in the 2.0 mg/kg dosing group. Blood pressure decline was mainly dependent on the initial propofol starting dose rather than the cumulative propofol dose. Conclusion Propofol causes a dose‐dependent profound and prolonged decrease in blood pressure. The use of propofol should be carefully considered. When using propofol, starting with a low dose and titrating according to sedative effect seems the safest strategy.