Propofol infusion for sedation of patients with head injury in intensive care

Farling, P.; Johnston, J. R.; Coppel, D. L.

doi:10.1111/j.1365-2044.1989.tb11228.x

Cited by 85 publications

(39 citation statements)

References 14 publications

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“…This resulted in maintenance of the MAP at baseline levels with a reduction in ICP providing an overall increase in CPP. The cardiovascular effects of propofol can be lessened by slow administration (over 5–10 min) of bolus doses or by using only a continuous infusion without bolus doses as illustrated by the report of Farling et al [14]. In addition to providing adequate control of ICP, propofol resulted in effective sedation in both cases when escalating doses of midazolam and an opioid were ineffective.…”

Section: Discussionmentioning

confidence: 88%

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Propofol for Sedation and Control of Intracranial Pressure in Children

1999

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Following central nervous system insults, control of intracranial pressure may lessen the incidence of morbidity and mortality. Therapies to control intracranial pressure include osmolar agents, prevention of and control of seizures, drainage of cerebrospinal fluid, hypothermia, and barbiturates. Control of agitation and excessive patient movement are additional components in the management of ICP. Although opioids and benzodiazepines are generally effective, in a small subset of patients, alternative agents may be necessary. The authors present 2 children with increased ICP in whom propofol was used to provide sedation and control ICP. The use of propofol in this setting and its possible applications in the children with increased ICP are discussed.

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Section: Discussionmentioning

confidence: 88%

“…Farling et al [14]reported their experience with propofol for sedation in 10 adult patients with closed head injuries. Propofol was administered as a continuous infusion of 2–4 mg/kg/h for 24 h. Additional therapy for increased ICP included mannitol and hyperventilation.…”

Section: Discussionmentioning

confidence: 99%

Propofol for Sedation and Control of Intracranial Pressure in Children

1999

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“…Propofol also has anticonvulsant properties and reduces ICP which can be advantageous in sedating a patient with epilepsy or a patient with concerns for obstructive hydrocephalus due to a malfunctioning ventriculoperitoneal shunt to obtain diagnostic neuroradiologic imaging [44–46]. While there have been cases of propofol providing adequate sedation and successfully treating intracranial hypertension [47, 48], several pediatric traumatic brain injury case reports have reported metabolic acidosis and death in patients on prolonged (24 hrs) continuous infusion of propofol [49–53]. In the 2003 published guidelines for the care of severe pediatric traumatic brain-injured patients, “continuous infusion of propofol is not recommended” [54].…”

Section: Resultsmentioning

confidence: 99%

Sedation and Analgesia in Children with Developmental Disabilities and Neurologic Disorders

Kilbaugh

Friess

Raghupathi

et al. 2010

International Journal of Pediatrics

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Sedation and analgesia performed by the pediatrician and pediatric subspecialists are becoming increasingly common for diagnostic and therapeutic purposes in children with developmental disabilities and neurologic disorders (autism, epilepsy, stroke, obstructive hydrocephalus, traumatic brain injury, intracranial hemorrhage, and hypoxic-ischemic encephalopathy). The overall objectives of this paper are (1) to provide an overview on recent studies that highlight the increased risk for respiratory complications following sedation and analgesia in children with developmental disabilities and neurologic disorders, (2) to provide a better understanding of sedatives and analgesic medications which are commonly used in children with developmental disabilities and neurologic disorders on the central nervous system.

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“…Several older studies found minor ICP decreases after prolonged propofol infusion. 29,30 In a randomized controlled trial, Kelly et al 17 compared end points for patients sedated with either propofol or morphine sulfate and found improved ICP control and lower therapeutic intensity in the propofol group. The rapidly metabolized narcotic fentanyl is also commonly deployed but with relatively unclear effects on ICP.…”

Section: Discussionmentioning

confidence: 98%