Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 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.

PubMed Disclaimer

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.

References

    1. Maheshwari R, Tracy M, Badawi N, Hinder M. Neonatal endotracheal intubation: how to make it more baby friendly. J Paediatr Child Health. 2016;52(5):480‐486. - PubMed
    1. Byrne E, MacKinnon R. Should premedication be used for semi‐urgent or elective intubation in neonates? Arch Dis Child. 2006;91:79‐83. - PMC - PubMed
    1. Carbajal R, Eble B, Anand KJS. Premedication for tracheal intubation in neonates: confusion or controversy? Semin Perinatol. 2007;31:309‐317. - PubMed
    1. Anand KJ, International evidence‐based group for neonatal pain . Consensus statement for the prevention and management of pain in the newborn. Arch Pediatr Adolesc Med. 2001;155:173‐180. - PubMed
    1. Kumar P, Denson SE, Mancuso TJ, Committee on Fetus and Newborn, Section on Anesthesiology and pain Medicine . Premedication for nonemergency endotracheal intubation in the neonate. Pediatrics. 2010;125(3):608‐615. - PubMed

Publication types