Clinical evaluation of propofol as sedative for endotracheal intubation in neonates
Article first published online: 27 AUG 2013
©2013 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd
Volume 102, Issue 11, pages e487–e492, November 2013
How to Cite
Simons, S., van der Lee, R., Reiss, I. K. and van Weissenbruch, M. (2013), Clinical evaluation of propofol as sedative for endotracheal intubation in neonates. Acta Paediatrica, 102: e487–e492. doi: 10.1111/apa.12367
- Issue published online: 3 OCT 2013
- Article first published online: 27 AUG 2013
- Accepted manuscript online: 25 JUL 2013 02:46AM EST
- Manuscript Accepted: 22 JUL 2013
- Manuscript Revised: 16 JUL 2013
- Manuscript Received: 15 APR 2013
- Netherlands Organisation for Health Research and Development
To determine the effects of propofol for endotracheal intubation in neonates in daily clinical practice.
We prospectively studied the pharmacodynamic effects of intravenous propofol administration in neonates who needed endotracheal intubation at the neonatal intensive care unit.
Propofol was used for 62 intubations in neonates with postmenstrual ages ranging from 24 + 3 weeks to 44 + 5 weeks and bodyweights ranging from 520 to 4380 g. A 2 mg/kg bodyweight propofol starting dose was sufficient in 37% of patients; additional propofol was needed less often on the first postnatal day. The mean amount of propofol used was 3.3 (±1.2) mg/kg. The success rate of intubation depended on the experience of the physician and was related to the total administered amount of propofol. Hypotension occurred in 39% of patients and occurred more often at the first postnatal day. In 15% of procedures, propofol mono therapy was insufficient.
This study shows that high doses of propofol are needed to reach effective sedation in neonates for intubation, with hypotension as a side effect in a considerable percentage of patients. Further research in newborn patients needs to identify optimal propofol doses and risk factors for hypotension.