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[Propofol for anesthesia and short-term sedation. The final word on use in children under three years]
P Reinhold1, G Kraus, E Schlüter
1Klinik für Anästhesiologie und operative Intensivmedizin, Klinikum Kreis Herford, Herford.
Insights
Propofol is a safe and effective anesthetic for children older than three years. Literature suggests no pharmacokinetic or pharmacodynamic reasons to exclude younger children from its use in anesthesia.
Area of Science:
- Anesthesiology
- Pharmacology
Context:
- Propofol has been used for over a decade for sedation and hypnosis in anesthesia.
- Current approval restricts its use to children older than three years.
Purpose:
- To evaluate the safety and efficacy of propofol in pediatric anesthesia.
- To determine if pharmacokinetic or pharmacodynamic data support restricting propofol use in younger children.
Summary:
- Extensive literature data indicate no pharmacokinetic or pharmacodynamic contraindications for using propofol in children younger than three years.
- Propofol can be safely administered for anesthesia, as a supplemental hypnotic, or for short-term interventions in this age group.
Impact:
- This review supports the expanded use of propofol in pediatric anesthesia.
- Highlights the need to reconsider current age restrictions for propofol administration in neonates and infants.
Abstract:
Since its introduction in clinical use more than ten years ago, propofol is well appreciated for sedation and supplemental hypnosis in anaesthesia. However the substance is approved only for anaesthesia in children elder than three years. As can be substantiated by many data reported in literature, there are no pharmacokinetic or pharmacodynamic reasons whatsoever to withhold propofol from the younger children; this applies both to the use as a narcotic supplement and as a short term hypnotic for diagnostic and therapeutic interventions.