Publication:

Effective dose of propofol for smooth induction in midazolam premedicated and in unpremedicated children

Background Propofol, an intravenous (IV) anaesthetic agent, is widely used in paediatric day care surgeries. Present study was conducted to determine clinically effective dose of Propofol for smooth induction in children.

Methods This randomized controlled study was conducted in 100 children of American Society of Anaesthesia (ASA) grade I and II, posted for short genitourinary surgeries. Group P patients received premedication with injection glycopyrrolate and midazolam IV. Group U patients were unpremedicated. Both groups were split in five subgroups with ten patients in each as per propofol dose of 2.0, 2.5, 3.0, 3.5, and 4.0mgkg-1 respectively. Following observations were made-pain on injection site, facemask tolerance, repeat dose and total dose of Propofol required for smooth induction, time of recovery and complications like post-operative nausea and vomiting (PONV). All data was analyzed by using chi square test and student t test.

Results Demographic profile showed no significant difference. Mean dose of Propofol in group P was 3.29±0.51 mg kg-1 while for group U was 3.70±0.57mg kg-1. Facemask tolerance was maximum in group P5 (100%) followed by (80%) in U5. Mean dose of Propofol required for younger children 1-3 years (group P 3.46±0.43 mgkg-1 v/s group U 3.94±0.48 mgkg-1) was much higher than dose required for 7-10 years (group P 3.13±0.52 mgkg-1 and group U 3.18±0.59 mgkg-1) for both groups. Recovery time after anaesthesia was delayed in group P and complications were more in group U.

Conclusions Propofol is the drug of choice for paeditric ambulatory surgery. Midazolam premedication enhances the benefits.