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Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
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Anesthesia and Intubation of Preadolescent Mouse Pups for Cardiothoracic Surgery
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How do pediatric anesthesiologists define intraoperative hypotension?

Olubukola O Nafiu1, Terri Voepel-Lewis, Michelle Morris

  • 1Department of Anesthesiology, University of Michigan, Ann Arbor, MI 48109-0048, USA. onafiu@med.umich.edu

Paediatric Anaesthesia
|October 3, 2009
PubMed
Summary

Pediatric anesthesiologists lack a consensus definition for intraoperative hypotension (IOH). Most consider a 20-30% drop in systolic blood pressure (SBP) significant, but practices vary widely, impacting patient care and research.

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Area of Science:

  • Anesthesiology
  • Pediatric Medicine
  • Critical Care

Background:

  • Blood pressure (BP) monitoring is standard in pediatric anesthesia.
  • No universally accepted definition for pediatric intraoperative hypotension (IOH) exists.
  • This variability may affect patient care and research outcomes.

Purpose of the Study:

  • To survey pediatric anesthesiologists on their definitions of IOH.
  • To identify current practices regarding BP thresholds for hypotension in children.
  • To highlight the lack of consensus in defining pediatric IOH.

Main Methods:

  • A questionnaire-based survey was distributed to members of the Society of Pediatric Anesthesia (SPA) and the Association of Paediatric Anaesthetists (APA).
  • Participants were asked about demographic information and specific definitions of hypotension for various pediatric age groups undergoing inguinal herniorraphy.
  • Response rate was 56% (483/860).

Main Results:

  • 76% of respondents use a 20-30% reduction in baseline systolic blood pressure (SBP) to define significant hypotension.
  • Mean arterial pressure or SBP are the most commonly used parameters (86.7% and 72%, respectively).
  • SPA members quoted lower SBP values for hypotension than APA members (P = 0.001).

Conclusions:

  • Significant variability exists in the parameters and thresholds used to define and treat IOH in pediatric anesthesia.
  • A majority of anesthesiologists consider a 20-30% SBP reduction as indicative of hypotension.
  • The absence of a consensus definition for IOH poses challenges for consistent patient care and clinical research.