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Effect site concentrations of propofol producing hypnosis in children and adults: comparison using the bispectral

H R Muñoz1, L I Cortínez, M E Ibacache

  • 1Departamento de Anestesiología, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago, Chile. hmunoz@med.puc.cl

Acta Anaesthesiologica Scandinavica
|August 2, 2006
PubMed

Insights

The predicted effect site concentration (C(e)) of propofol for achieving a Bispectral Index (BIS) of 50 was similar in adults and children. This finding suggests that adult propofol concentrations are likely effective for pediatric anesthesia.

Area of Science:

  • Anesthesiology
  • Pharmacology
  • Pediatric Medicine

Background:

  • Current propofol dosing for pediatric anesthesia relies on adult data, potentially leading to inadequate anesthetic depth.
  • No prior studies have established the specific propofol concentration for effective hypnosis in children.

Purpose of the Study:

  • To determine the predicted effect site concentration (C(e)) of propofol required to achieve a Bispectral Index (BIS) of 50 in 50% of children and adults.
  • To compare propofol EC(e50) values between pediatric and adult populations.

Main Methods:

  • Utilized the up-and-down method of Dixon and Massey to determine the EC(e50) of propofol in 20 adults and 20 children.
  • Monitored patients with a BIS monitor during target-controlled infusion of propofol.
  • Defined a positive response as BIS < 50 and a negative response as BIS >= 50.

Main Results:

  • The mean EC(e50) for propofol was 3.75 microg/ml in adults and 3.65 microg/ml in children, with no statistically significant difference.
  • All patients with BIS < 50 were unarousable with tactile stimulation.
  • The prediction probability (P(K)) indicated a strong association between BIS and sedation score (0.99) in both groups.

Conclusions:

  • The predicted effect site concentration of propofol for achieving BIS = 50 is similar in adults and children aged 3-11 years.
  • Propofol concentrations effective for hypnosis in adults appear to be suitable for this pediatric population.
Abstract

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