Changes in respiratory and hemodynamic parameters during low-dose propofol sedation in combination with regional anesthesia for herniorrhaphy and genitourinary surgery in children

Silvio Zanaboni, Baruch Krauss, Raffaella Buscaglia, Claudia Montagnini, Angelo Gratarola, Jenny Gualino, Roberto Colombo, Francesco Della Corte

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Spontaneous vs mechanical ventilation during propofol sedation has been a subject of debate. We evaluated the safety of low-dose propofol sedation as an adjunct to regional anesthesia during herniorrhaphy and genitourinary surgery in infants and children. Methods: The study was conducted in a prospective, nonrandomized manner using a consecutive sample of 62 American Society of Anesthesiologists physical status class I patients between 5 months to 11 years of age in the surgery unit of an urban University Hospital. Propofol sedation (4-8 mg·kg-1·h-1 continuous infusion) was used with regional anesthesia (caudal, ilioinguinal/ iliohypogastric nerve or penile block with 0.2-0.375% ropivacaine). All children were spontaneously breathing without an anesthesia circuit. Respiratory and hemodynamic parameters were continuously recorded on all patients. One-way analysis of variance (anova) for repeated measurements was used to analyze changes in respiratory and hemodynamic parameters during the procedure. Results: Spontaneous ventilation was maintained in all patients with minimal changes in hemodynamic parameters. Heart rate, mean arterial pressure, and P ECO2 remained stable throughout the study period: 23/62 (37%) patients exhibited signs of developing intrinsic endexpiratory pressure (PEEPi) or the presence of PEEPi because of progressive reduction of expiratory time. Conclusions: Low-dose propofol sedation in combination with regional anesthesia for elective herniorrhaphy and genitourinary surgery in children maintains spontaneous ventilation and has minimal effects on hemodynamic parameters for sedation lasting

Original languageEnglish
Pages (from-to)934-941
Number of pages8
JournalPaediatric Anaesthesia
Volume17
Issue number10
DOIs
Publication statusPublished - Oct 2007

Keywords

  • Children
  • Propofol
  • Sedation

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Pediatrics, Perinatology, and Child Health

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