The utility of the perfusion index as an indicator of anesthetic depth for repeated propofol sedation in children: An observational study
- PMID: 37804009
- DOI: 10.1111/ped.15659
The utility of the perfusion index as an indicator of anesthetic depth for repeated propofol sedation in children: An observational study
Abstract
Background: Children receiving proton therapy require repeated sedation. In this study, we aimed to investigate the utility of the perfusion index (PI) for evaluating consciousness level during repeated propofol sedation.
Methods: In this prospective observational study, children aged from birth to 19 years old scheduled for proton therapy under repeated propofol sedation were enrolled. The primary outcome was the equivalence of PI values 5 min after anesthesia induction on consecutive sedation. Total consumption of propofol during sedation, time to reach the University of Michigan sedation scale (UMSS) score 1 after end of proton therapy, and duration of post-anesthesia care unit (PACU) stay were recorded.
Results: The PI values measured 5 min after induction of anesthesia were not equivalent to each other in consecutive sedation except for the second versus third (1st vs. 2nd: 97.5% CI: -1.34, 0.91; p = 0.206, 0.034; 2nd vs. 3rd: 97.5% CI: -0.87, 0.94; p = 0.023, 0.036 3rd vs. 4th: 97.5% CI: -2.08, -0.26; p < 0.99, <0.001; 4th vs. 5th: 97.5% CI: 0.21, 2.28; p < 0.001, >0.99; respectively). In consecutive sedation, there was not a significantly different difference in the time to reach UMSS score 1 (p > 0.99, all) for total consumption of propofol, time to reach UMSS score 1 after the end of proton therapy, and duration of PACU stay.
Conclusions: During repeated propofol sedation in children, PI was insufficient to be used as an indicator of consciousness level assessment. However, we suggest that the information related to repeated sedation provided by this study may be helpful in clinical practice.
Keywords: pediatric; perfusion index; propofol; proton therapy; sedation.
© 2023 Japan Pediatric Society.
References
REFERENCES
-
- Mohan R, Grosshans D. Proton therapy - present and future. Adv Drug Deliv Rev. 2017;109:26-44.
-
- Poludniowski G, Allinson NM, Evans PM. Proton radiography and tomography with application to proton therapy. Br J Radiol. 2015;88:20150134.
-
- Merchant TE. Proton beam therapy in pediatric oncology. Cancer J. 2009;15:298-305.
-
- Krishnamohan A, Siriwardana V, Skowno JJ. Using a pulse oximeter to determine clinical depth of anesthesia-investigation of the utility of the perfusion index. Paediatr Anaesth. 2016;26:1106-1111.
-
- Lima A, Bakker J. Noninvasive monitoring of peripheral perfusion. Intensive Care Med. 2005;31:1316-1326.
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
Research Materials
Miscellaneous