Factors affecting propofol dosage for sedation in pediatric oncology

There is limited reference data for determining the appropriate dose of propofol for individual patients. Therefore, we investigated the factors affecting propofol dosage for pediatric patients undergoing sedation for computed tomography (CT) simulation.

We retrospectively analyzed the electronic medical records of pediatric patients who underwent CT simulation for proton therapy following a cancer diagnosis at the National Cancer Center (Korea) between 1 May 2012 and 30 April 2016. We evaluated the following factors, which reflect comorbidities or chronic illness in pediatric oncology patients: age, tumor lesion, preterm birth, American Society of Anesthesiologists (ASA) classification, pre-sedation temperature, history of propofol use, nothing by mouth time, chemotherapy history, pre-sedation laboratory findings, regular medication (opioids, anticonvulsants), and use of diuretics. A regression analysis was performed and P < 0.05 was considered statistically significant.

Electronic medical records of 84 pediatric cancer patients were used in the analysis. Patients in ASA classes 1-2 required approximately 43% more propofol than patients in classes 3-4 (exp(β), 1.43; 95%CI: 1.21-1.69, P < 0.001).

American Society of Anesthesiologists class 3 or 4 is an independent indicator of decreased propofol dosage for pediatric oncology patients during sedation.