PROPOFOL: A REVIEW OF ITS ROLE IN PEDIATRIC ANESTHESIA AND SEDATION

摘要: Propofol is an intravenous agent used commonly for the induction and maintenance of anesthesia, procedural, critical care sedation in children. The mechanisms action on central nervous system involve interactions at various neurotransmitter receptors, especially gamma-aminobutyric acid A receptor. Approved use USA by Food Drug Administration 1989, its anesthesia children less than 3 years age still remains off-label. Despite wide pediatric there conflicting literature about safety serious adverse effects particular subsets Particularly as are not “little adults”, this review, we emphasize maturational aspects propofol pharmacokinetics. myriad pharmacokinetic-pharmacodynamic studies ability to allometrical scaling smooth out differences due size age, no optimal model that can be target controlled infusion pumps providing closed loop total As commercial formulation a nutrient-rich emulsion, risk bacterial contamination exists despite mandating addition antimicrobial preservative, calling manufacturers’ directions discard open vials after 6 h. While has advantages over inhalation such postoperative nausea emergence delirium children, pain injection problem even with newer formulations. known depress mitochondrial function uncoupling oxidative phosphorylation. This implications diseases occurrence propofol-related syndrome, rare but seriously life-threatening complication propofol. At time direct evidence humans propofol-induced neurotoxicity infant brain; however, current concerns neuroapoptosis developing brains induced persist continue focus research.