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. 2020 Dec;109(12):2539-2546.
doi: 10.1111/apa.15282. Epub 2020 Apr 20.

Propofol in neonates causes a dose-dependent profound and protracted decrease in blood pressure

Ellen H M de Kort  1   2 , Jos W R Twisk  3 , Ellen P G van T Verlaat  2 , Irwin K M Reiss  2 , Sinno H P Simons  2 , Mirjam M van Weissenbruch  4
Affiliations

Propofol in neonates causes a dose-dependent profound and protracted decrease in blood pressure

Ellen H M de Kort et al. Acta Paediatr. 2020 Dec.

Abstract

Aim: To analyse the effects of different propofol starting doses as premedication for endotracheal intubation on blood pressure in neonates.

Methods: Neonates who received propofol starting doses of 1.0 mg/kg (n = 30), 1.5 mg/kg (n = 23) or 2.0 mg/kg (n = 26) as part of a previously published dose-finding study were included in this analysis. Blood pressure in the 3 dosing groups was analysed in the first 60 minutes after start of propofol.

Results: Blood pressure declined after the start of propofol in all 3 dosing groups and was not restored 60 minutes after the start of propofol. The decline in blood pressure was highest in the 2.0 mg/kg dosing group. Blood pressure decline was mainly dependent on the initial propofol starting dose rather than the cumulative propofol dose.

Conclusion: Propofol causes a dose-dependent profound and prolonged decrease in blood pressure. The use of propofol should be carefully considered. When using propofol, starting with a low dose and titrating according to sedative effect seems the safest strategy.

Keywords: blood pressure; hypotension; neonate; premedication; propofol.

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Conflict of interest statement

All authors have no potential conflict of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Changes of systolic, diastolic and mean blood pressure after start of propofol in 3 dosing groups
FIGURE 2
FIGURE 2
Changes in MBP after correcting for volume resuscitation and extra propofol administration
See this image and copyright information in PMC

Comment in

  • Propofol in preterm neonates.
    Meyer S, Bay J, Poryo M. Meyer S, et al. Acta Paediatr. 2021 May;110(5):1692. doi: 10.1111/apa.15759. Epub 2021 Jan 21. Acta Paediatr. 2021. PMID: 33438289 No abstract available.
  • Reply to Letter 'Propofol in preterm neonates'.
    de Kort EHM, Simons SHP, van Weissenbruch MM. de Kort EHM, et al. Acta Paediatr. 2021 May;110(5):1693. doi: 10.1111/apa.15755. Epub 2021 Jan 27. Acta Paediatr. 2021. PMID: 33445209 No abstract available.

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