Propofol - In One-Day Surgery in Children

Research Article

Austin J Anesthesia and Analgesia. 2020; 8(2): 1091.

Propofol - In One-Day Surgery in Children

Nasibova EM*

Department of Anesthesia, Azerbaijan Medical University, Baku

*Corresponding author: Nasibova EM, Department of Anesthesia, Azerbaijan Medical University, Baku

Received: June 02, 2020; Accepted: July 01, 2020; Published: July 08, 2020


Propofol (diprivan) is the drug of choice in one-day surgery in children. The use of the drug provides rapid awakening (due to rapid redistribution and short half-life) and a minimum incidence of postoperative complications. Total intravenous anesthesia with propofol infusion or bolus administration is an easily managed anesthesiologist, anesthesia comfortable for the patient (1, 2, 3, 4, 5,6, 7, 8, 9,10,11,12,13).

The aim of the study: Optimization of anesthetic benefits in one-day surgery by using propofol.

Keywords: Propofol; One-Day Surgery; Premedication

Material and Methods

The study included 58 patients operated on for inguinal and umbilical hernias, dropsy of testicular membranes, cryptorchidism, varicocele, hemangiomas of various localization, phimosis and paraphimosis. Depending on the age of the children, this group was divided into 3 subgroups: IA (n = 12) age 0-3 years, IB (n = 33) - 4-7 years old and IC (n = 13) - 8-16 years old. This study was carried out in five stages. For intravenous anesthesia in children, you must have access to a vein. To prevent a negative attitude of the child to this procedure, the local anesthetic drug EMLA was used. EMLA - eutectic mixture of local anesthetic, is an emulsion system in which the oil phase consists of an eutectic mixture of the bases of lidocaine and prilocaine in a 1: 1 ratio. The drug is available in the form of 5% cream and patch. One gram of cream or one patch contains 25 mg of prilocaine. EMLA cream was applied 2-3 g on a selected area, which was then tightly covered with a gauze cloth. After removing the wipes, the remaining cream was removed. 40 minutes after applying the cream with the introduction of the needle, a motor reaction to the manipulation was not observed. At the initial stage of the use of propofol in our clinic, we titrated the initial and maintenance doses of it. To date, we have experience with the use of propofol in various manipulations and surgical interventions in more than 3,000 children aged 0 to 16 years. The optimal, according to clinical data, induction dose of propofol in children older than 5 years was 3.5 ± 0.3 and 4.0 ± 0.4 mg/kg in children under 5 years of age [1]. Approximately 30- 40 seconds after the start of propofol administration, rapid breathing occurred in all patients, which then turned into apnea in the majority. During induction, a decrease in oxygen saturation to 92-94% was noted. Clinically, in 5 patients, motor sweeping movements were noted and in 6 patients - short-term hypoventilation. After oxygen hyperventilation, an increase in SpO2 of 98-99% was noted. Central analgesia was carried out with fentanyl at the rate of 1.5-2 μg/kg [2,3].

The Results of the Study

Changes in the indicators of central hemodynamics and external respiration relative to the first stage during intravenous total anesthesia (propofol + fentanyl) are presented in Table 1.