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Short-Term Propofol Infusion and Associated Effects on Serum Lactate in Pediatric Patients

Sean Indra1, Haitham Haddad, Mary Ann OʼRiordan

  • 1From the *Children's Hospital of Michigan, Detroit, MI; and †Rainbow Babies and Children's Hospital, University Hospitals, Case Medical Center, Cleveland, OH.

Pediatric Emergency Care
|November 3, 2017
PubMed

Insights

Short-duration propofol sedation in children did not increase serum lactate levels, indicating no significant metabolic stress. This suggests outpatient propofol use is safe for pediatric procedural sedation.

Area of Science:

  • Pediatric Anesthesiology
  • Clinical Pharmacology
  • Metabolic Medicine

Background:

  • Propofol infusion syndrome (PIS) is a rare but serious complication associated with high-dose, long-duration propofol infusions.
  • The metabolic stress response, indicated by serum lactate levels, is a key marker for PIS.
  • The safety of short-duration propofol sedation in pediatric outpatient settings regarding metabolic stress remains understudied.

Purpose of the Study:

  • To investigate the relationship between short-duration propofol procedural sedation and adverse metabolic stress in children.
  • To assess changes in serum lactate levels as a marker of metabolic stress following outpatient propofol administration in pediatric patients.

Main Methods:

  • A prospective, longitudinal study involving 50 pediatric patients (ages 2-18 years) undergoing outpatient procedural sedation.
  • Patients received propofol via bolus or bolus and continuous infusion.
  • Serum lactate levels were measured pre- and post-procedure.

Main Results:

  • The average procedure length was 40.3 minutes with a mean propofol dose of 8.2 mg/kg.
  • A significant decrease in serum lactate was observed post-procedure (average change of -0.3 mmol/L, P < 0.001).
  • No significant association was found between propofol dosage or procedure length and postprocedure lactate values.

Conclusions:

  • Short-duration propofol procedural sedation in children is not associated with an increase in serum lactate.
  • This suggests that the risks of propofol infusion syndrome may be significantly lower with short-duration, outpatient use compared to long-duration/high-dose infusions.
  • Propofol appears to be a safe option for procedural sedation in pediatric outpatient settings without inducing significant metabolic stress.
Abstract

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