This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Reeves, S. T.
Right arrow Articles by Tobin, D. P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Reeves, S. T.
Right arrow Articles by Tobin, D. P.
Related Collections
Right arrow Therapeutics & Toxicology
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?
PEDIATRICS Vol. 114 No. 1 July 2004, pp. e74-e76

ELECTRONIC ARTICLE

Conscious Sedation of Children With Propofol Is Anything but Conscious

Scott T. Reeves, MD, Jeana E. Havidich, MD and D. Patrick Tobin, CRNA

Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, South Carolina

Objective. To determine the depth of sedation required for bone marrow aspiration and intrathecal injection of chemotherapeutic agents in children using a bispectral (BIS) index monitor and clinical assessment by an independent observer.

Methods. Sixteen children who were undergoing 19 intrathecal chemotherapy and bone marrow aspirations were enrolled in the study. Their ages ranged from 23 months to 190 months with a mean of 79 months. The BIS index was recorded every 5 minutes by an independent observer. The patients received only intravenous propofol for sedation. There were no complications during the procedures.

Results. The mean BIS score was 62.8 ± 9.6. The mean low BIS score was 29.7 ± 13.7, indicating a level of deep sedation and/or general anesthesia was necessary to induce the desired stated of consciousness that would permit the practitioner to perform the procedure. The average dose of propofol was 166 ± 47 µg/kg/min. Mean Aldrete score for level of consciousness was 0.9 ± 0.4, indicating a depressed level of consciousness. The mean activity level was 1.0 ± 0.4, indicating impaired movement.

Conclusions. Children who undergo conscious sedation with propofol for intrathecal chemotherapy and bone marrow aspiration demonstrate BIS values and clinical assessments consistent with deep sedation. Because of an increased risk of adverse events when children undergo deep sedation, appropriate parental informed consent, age-appropriate resuscitative equipment, and skilled anesthesia personnel should be present for rescue in the event of cardiovascular and respiratory complications from deep sedation.

Key Words: BIS index monitor • sedation • children

Abbreviations: JCAHO, Joint Commission on Accreditation of Healthcare Organizations • BIS, bispectral • EEG, electroencephalogram

Received for publication Jan 7, 2004; Accepted Feb 4, 2004.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Anesth. Analg.Home page
J. P. Cravero, M. L. Beach, G. T. Blike, S. M. Gallagher, J. H. Hertzog, and Pediatric Sedation Research Consortium
The Incidence and Nature of Adverse Events During Pediatric Sedation/Anesthesia With Propofol for Procedures Outside the Operating Room: A Report From the Pediatric Sedation Research Consortium
Anesth. Analg., March 1, 2009; 108(3): 795 - 804.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
S. E. Zgleszewski, D. Zurakowski, P. J. Fontaine, M. D'Angelo, and K. P. Mason
Is Propofol a Safe Alternative to Pentobarbital for Sedation during Pediatric Diagnostic CT?
Radiology, May 1, 2008; 247(2): 528 - 534.
[Abstract] [Full Text] [PDF]

Home page
 Emerg. Med. J.Home page
K Hogan, A Sacchetti, L Aman, and D Opiela
The safety of single-physician procedural sedation in the emergency department
Emerg. Med. J., December 1, 2006; 23(12): 922 - 923.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
K J S Anand and R W Hall
Pharmacological therapy for analgesia and sedation in the newborn.
Arch. Dis. Child. Fetal Neonatal Ed., November 1, 2006; 91(6): F448 - F453.
[Abstract] [Full Text] [PDF]