Propofol for procedural sedation in children

Propofol (1)iprivan; Astra Zeneea. Wilmington, DE) is a potent anesthetic/ sedative agent characterized by rapid onset of sedation and short recovery time. Because of these pharmacologic qualities, propofol has become popular for use during short diagnostic and therapeutic procedures in outpatient settings for both adults and children. For induction of sedation, propofol is slowly administered intravenously as a bolus of 1 to 3 mg/kg, followed by either repeated boluses or a continuons infusion of 50 to 160 μg/kg/min. Because propofol is a pure sedative, the administration of an analgesic agent during painful procedures is recommended, Children sedated with propofol may develop arterial oxygen desaturation and/or a decrease in mean arterial blood pressure. These adverse effects are usually transient and most will resolve when the infusion is discontinued. The current experience of nonanesthesiologists using propofol in the pediatric emergency department is very limited. Although emergency physicians are well qualified in managing airway emergencies, further studies are needed to show the safety profile of propofol in this setting.