Comparison of Propofol and Thiopental for Rapid Anesthesia Induction in Infants

Abstract

We compared the hemodynamic response to laryngoscopy and intubation, as well as emergence and recovery times, when propofol or thiopental were used for rapid intravenous induction of anesthesia in 59 infants undergoing repair of inguinal hernia. An intravenous catheter was inserted under N2O analgesia and atropine 0.01 mg/kg was administered to all patients. Subsequent induction with propofol (3 mg/kg), thiopental (5 mg/kg), or halothane (2%) was followed with succinylcholine (2 mg/kg) and tracheal intubation. Ventilation was manually assisted during surgery, and tracheas were extubated when patients were completely awake. Infants who received propofol showed less hypertensive response to intubation than those who received thiopental or halothane. In the 1- to 6-mo age group, emergence (extubation) time was significantly longer for infants who received thiopental (10.2 +/- 1.4 min) than for those who received propofol or halothane (5.5 +/- 2.5 and 6.2 +/- 1.3 min, respectively). Infants who received thiopental induction had a higher incidence of perioperative airway complications than all others. There was no significant difference in the recovery and discharge times among the three groups. We conclude that when rapid intravenous induction is required for infants, propofol is more effective than thiopental in obtunding the hypertensive response to intubation, and in young infants (1-6 mo) it results in more prompt emergence after short surgical procedures.

Should we reconsider awake neonatal intubation? A review of the evidence and treatment strategies

“…In 1994, Schrum et al . compared propofol 3 mg·kg –1 , thiopentone 5 mg·kg –1 and halothane 2% as induction agents in two age groups: 1–6 months and 7–12 months (58). The infants receiving propofol showed a lesser hypertensive response during intubation than those receiving thiopentone or halothane and in the younger age group the time to awake extubation from anaesthesia was halved; 5.5 ± 2.5 vs. 10.3 ± 1.4 min.…”

Induction characteristics of 2% propofol in children

“…anaesthetic agent which is now used routinely in paediatric anaesthesia. 1 Spontaneous movement is one of the side effects observed during induction of anaesthesia with 1% propofol. 2 It was demonstrated that increasing the loading dose from 3 to 5 mg kg 91 resulted in a significant decrease in these movements.…”

Assessment of Intubating Conditions with Different Doses of Propofol without Muscle Relaxant in Children

“…Also baroreceptor reflex control of HR may be depressed by propofol [15]. The possible development of severe hypotension is the limiting factor with the use of propofol although Schrumet al [21] demonstrated that it was transient in healthy, normovolemic children. Topical laryngeal spraying of lidocaine as suggested by Abouleishet al [22] can be used as an adjunct to the technique of tracheal intubation without muscle relaxant for further improving the intubating score with no effects on hemodynamics.…”