Home > Journals > Minerva Anestesiologica > Past Issues > Articles online first > Minerva Anestesiologica 2021 Aug 02

CURRENT ISSUE
 

JOURNAL TOOLS

eTOC
To subscribe
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Publication history
Reprints
Permissions
Cite this article as
Share

 

 

Minerva Anestesiologica 2021 Aug 02

DOI: 10.23736/S0375-9393.21.15716-5

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Perioperative sedation requirements of infants aged 0 to 3 months subjected to lower-body surgery under caudal blockade: a randomized controlled trial

Werner SCHMID 1 , Peter MARHOFER 2, 3, Oliver KIMBERGER 1, Daniela MARHOFER 1, Stephan KETTNER 4, 5

1 Department of Anesthesiology and General Intensive Care Medicine, Medical University of Vienna, Vienna, Austria; 2 Department of Anesthesiology and General Intensive Care Medicine, Medical University of Vienna, Vienna, Austria; 3 Department of Anesthesiology and Intensive Care Medicine, Orthopaedic Hospital Speising, Vienna, Austria; 4 Department of Anesthesiology and Intensive Care, Hospital Hietzing, Vienna Hospital Association, Vienna, Austria; 5 Karl Landsteiner Institute for Anesthesiology and Intensive Care Medicine, Vienna, Austria


PDF


BACKGROUND: It remains unclear how much sedation is required for subumbilical surgery under caudal blockade, and sedatives may carry a poorly understood risk of late sequelae in infants. We designed a randomized controlled study to evaluate total propofol consumption and perioperative sedation quality with the avoidance of continuous perioperative sedation in infants undergoing surgery under caudal anesthesia.
METHODS: Thirty-two infants (age: 0−3 months) were randomized to one of two groups in which perioperative administration of propofol was provided either "as needed" or by continuous infusion (5 mg kg−1 h−1). After induction of anesthesia via a facemask with sevoflurane, a venous access was established and 1 ml kg−1 of ropivacaine 0.35% was injected for caudal anesthesia. Intraoperative stress was assessed by repeated recording Comfort Behavioral Scale scores and heart rates.
RESULTS: Significantly (p = 0.0001) less propofol was administered in the as-needed group (0.7 ± 1.4 mg/kg) than in the continuous-infusion group (3.0 ± 1.6 mg/kg). This difference was not reflected in different requirements of additional intraoperative sedation (0.5 ± 0.8 mg/kg in 5 versus 0.6 ± 1.0 mg/kg in 4 cases; p = 0.76).
CONCLUSIONS: As needed propofol administration offers no disadvantage in terms of intraoperative sedation, but significant dose reductions can be achieved by avoiding continuous propofol infusion.


KEY WORDS: Anaesthesia, caudal; Ultrasonography; Ropivacaine; Infant; Deep sedation

top of page