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Propofol sedation by emergency physicians for elective pediatric outpatient procedures
Elisabeth Guenther1, Charles G Pribble, Edward P Junkins
1Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City 84102, USA. elisabeth.guenther@hsc.utah.edu
Annals of Emergency Medicine
|November 25, 2003
Summary
Pediatric emergency physicians safely administered propofol sedation for painful outpatient procedures in children, ensuring successful completion and rapid recovery. This study highlights the efficacy of propofol for procedural sedation in pediatric emergency settings.
Area of Science:
- Pediatric Emergency Medicine
- Anesthesiology
- Pharmacology
Background:
- Painful procedures in children often require sedation for patient comfort and procedural success.
- Propofol is a widely used anesthetic agent, but its administration in pediatric emergency settings for outpatient procedures requires careful evaluation.
Purpose of the Study:
- To describe the efficacy and safety of propofol sedation administered by pediatric emergency physicians for painful outpatient procedures.
- To evaluate the outcomes of propofol sedation in a pediatric emergency department-affiliated short-stay unit.
Main Methods:
- A prospective, consecutive case series of 291 sedation events in 87 pediatric patients was conducted.
- Patients underwent medical evaluation and fasting, received supplemental oxygen, and had sedation depth and vital signs monitored.
- Propofol was manually titrated by a sedation team to achieve the desired level of sedation for procedures like lumbar puncture and chemotherapy administration.
Main Results:
- The study included 87 patients, with a median age of 6 years; 72% were oncology patients.
- Common procedures included lumbar puncture (43%) and intrathecal chemotherapy (31%).
- All procedures were successfully completed with propofol sedation, with minor adverse events (airway obstruction 4%, apnea 1%) managed effectively. Median total propofol dose was 3.5 mg/kg.
Conclusions:
- Propofol sedation administered by pediatric emergency physicians is safe and effective for facilitating short, painful outpatient procedures in children.
- The sedation protocol resulted in successful procedure completion and rapid patient recovery.