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Propofol use in newborns and children: is it safe? A systematic review

Eduardo Mekitarian Filho1, Mariana Barbosa Riechelmann2

  • 1Universidade de São Paulo (USP), Faculdade de Medicina, São Paulo, SP, Brazil; Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil; Universidade Cidade de São Paulo (Unicid), Faculdade de Medicina, São Paulo, SP, Brazil; Hospital Santa Catarina, São Paulo, SP, Brazil.

Jornal De Pediatria
|January 12, 2020
PubMed

Insights

Propofol is a safe hypnotic for pediatric procedures like endoscopy and MRI. While adverse events are noted, they are typically low-risk, but emergency preparedness is crucial for non-anesthesiologists.

Area of Science:

  • Pediatric Anesthesiology
  • Clinical Pharmacology
  • Evidence-Based Medicine

Background:

  • Propofol is a widely used hypnotic agent in pediatric medicine.
  • Understanding its indications and adverse events is crucial for safe administration.
  • Recent literature shows increasing use in neonates and diverse pediatric scenarios.

Purpose of the Study:

  • To identify primary uses of propofol in pediatric patients.
  • To evaluate the frequency and severity of adverse events associated with propofol.
  • To assess the safety profile of propofol in various pediatric clinical settings.

Main Methods:

  • A systematic review of major biomedical databases (PubMed, EMBASE, Cochrane, SciELO) was conducted.
  • The review focused on clinical trials and relevant articles published within the last five years.
  • Articles were assessed for quality and potential bias following PRISMA guidelines.

Main Results:

  • The review identified upper digestive endoscopy and magnetic resonance imaging as primary indications for propofol in children.
  • A comprehensive list of adverse events was documented, though most were classified as low risk.
  • The number of studies on pediatric propofol use, including in neonates, is growing.

Conclusions:

  • Propofol demonstrates a favorable safety and efficacy profile in pediatric populations.
  • Non-anesthesiologists administering propofol must have immediate access to emergency care, particularly for airway complications.
  • Further research is needed to expand the use of propofol in broader pediatric settings and by general pediatricians.
Abstract

Keywords:
Adverse eventsChildrenCriançasEventos adversosPediatriaPediatricsPropofolPropofol infusion syndromeSíndrome de infusão de propofol

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