Endoscopy 2000; 32(10): 788-791
DOI: 10.1055/s-2000-7713
Original Article
Georg Thieme Verlag Stuttgart ·New York

Propofol Sedation for Endoscopic Procedures in Children

Y. Elitsur 1 , P. Blankenship 2 , Z. Lawrence 1
  • 1 Dept. of Pediatrics, Pediatric Gastroenterology Division, Marshall University, School of Medicine, Huntington, West Virginia, USA
  • 2 Endoscopy Suite, Cabell-Huntington Hospital, West Virginia, USA
Further Information

Publication History

Publication Date:
31 December 2000 (online)

Background and Study Aims: Propofol sedation has been used successfully in various outpatient minor procedures in children. Limited data are available on the usefulness of propofol sedation during gastrointestinal endoscopic procedures in children. The aim of this study was to evaluate our experience of propofol sedation in pediatric gastrointestinal endoscopic procedures.

Materials and Methods: The charts of all children who had undergone diagnostic endoscopic procedures, and were sedated by propofol, were retrospectively reviewed. Demographic data, cardiovascular monitoring, and drug dosages were recorded. Patients evaluated their sedation efficacy by answering a questionnaire before discharge.

Results: A total of 104 children underwent 107 procedures. Propofol alone was given in 19 procedures and in combination with midazolam and/or fentanyl in 88 procedures. All procedures were completed and significant complication occurred in only one patient. No significant difference was observed in the amount of sedative drugs or recovery time between upper and lower endoscopic procedures. A lower propofol dosage was needed when a combination of drugs was given compared to propofol drug alone. Patients' assessment of their sedation showed that the vast majority had experienced postendoscopic amnesia.

Conclusion: Propofol sedation for endoscopic procedures is safe and acceptable for children. Propofol sedation should be offered to young children, especially those who express significant anxiety.

References

  • 1 Squires R H, Morriss F, Schluterman S, et al. Efficacy, safety, and cost of intravenous sedation versus general anesthesia in children undergoing endoscopic procedures.  Gastrointest Endosc. 1995;  41 99-104
  • 2 Balsells F, Wyllie R, Kay M, Steffen R. Use of conscious sedation for lower and upper gastrointestinal endoscopic examinations in children, adolescents, and young adults: a twelve-year review.  Gastrointest Endosc. 1997;  45 375-380
  • 3 Ament M E, Brill J E. Pediatric endoscopy, deep sedation, conscious sedation, and general anesthesia - what is best?.  Gastrointest Endosc. 1995;  41 173-175
  • 4 Bahal-O'Mara N, Nahata M C, Murray R D, et al. Efficacy of diazepam and meperidine in ambulatory pediatric patients undergoing endoscopy: a randomized, double-blind trial.  J Pediatr Gastroenterol Nutr. 1993;  16 387-392
  • 5 Bryson H M, Fulton B R, Faulds D. Propofol - An update of its use in anesthesia and conscious sedation.  Drug. 1995;  50 513-559
  • 6 McDowall R H, Scher C S, Barst S M. Total intravenous anesthesia for children undergoing brief diagnostic or therapeutic procedures.  J Clin Anesth. 1995;  7 273-280
  • 7 Harling D W, Harrison D A, Dorman T, Barker I. A comparison of thiopenthone/isoflurane anaesthesia vs. propofol infusion in children having repeat minor hematological procedures.  Pediatr Anesth. 1997;  7 19-23
  • 8 Kaddu R, Bhattacharya D, Thomas R, Tolia V. Comparison of propofol (P) vs. general anesthesia (GA) for pediatric endoscopic procedures (abstract).  Am J Gastroenterol. 1999;  94 2754
  • 9 Rosenberg D, Winters J, Laham J, Montes R. Experience with propofol in pediatric sedation for invasive gastrointestinal and other procedures (abstract).  J Pediatr Gastroenterol Nutr. 1997;  25 464
  • 10 Seal R F, Nadwidny L A, Smith L J, et al. Propofol vs. diazepam/meperidine for pediatric GI endoscopy: a prospective comparison (abstract).  Gastrointest Endosc. 1995;  41 342
  • 11 Carlsson U, Grattidge P. Sedation for upper gastrointestinal endoscopy: A comparative study of propofol and midazolam.  Endoscopy. 1995;  27 240-243
  • 12 Heiman D R, Tolliver B A, Weis F R, et al. Patient-controlled anesthesia for colonoscopy using propofol: results of a pilot study.  South Med J. 1998;  91 560-564
  • 13 Van Houten J S, Pharm D, Steven A, et al. A randomized, prospective, double-blind comparison of midazolam (versed) and emulsified diazepam (Dizac) for opioid-based, conscious sedation in endoscopic procedures.  Am J Gastroenterol. 1998;  93 170-174
  • 14 Tolia V, Fleming S L, Kauffman R E. Randomized double-blind trial of midazolam and diazepam for endoscopic sedation in children.  Dev Pharmacol Ther. 1990;  14 141-147
  • 15 Hassall E. Should pediatric gastroenterologists be i. v. drug users?.  J Pediatr Gastroenterol Nutr. 1993;  16 370-372
  • 16 Vuyk J. Pharmacokinetics and pharmacodynamic interactions between opioids and propofol.  J Clin Anesth. 1997;  9 23S-26S
  • 17 Vuyk J. TCI: supplementation of drug interactions.  Anaesthesia. 1998;  53 (Suppl) 35-41

Y. Elitsur, M.D.

Dept. of Pediatrics Division of Gastroenterology Marshall University School of Medicine

1600 Medical Center Drive

Huntington, WV 25701-0195

USA

Fax: Fax:+ 1-304-691-1375

Email: E-mail:elitsur@marshall.edu

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