Propofol poses low risk in pediatric imaging studies, but risk increases with anesthesia duration

Jun 09, 2010

A new study finds that propofol, a well-known anesthesia medication, has a low occurrence of adverse events for children undergoing research-driven imaging studies. The study, led by a pediatric anesthesiologist now at Children's National Medical Center, showed a low incidence of adverse events and no long term complications when propofol was used to sedate children for imaging studies that require them to be still for long periods of time.

Lead author Zena Quezado, MD, director of the Pain Neurobiology Laboratory at the Sheikh Zayed Institute for Pediatric Surgical Innovation, also found, however, that propofol, a commonly used , does show an increased risk for respiratory, cardiovascular, and other side effects if anesthesia is administered over a long period of time or if the child has other complicating factors, including some systemic disease or an airway abnormality. It is also the first imaging study to show an increase in risk to the child with each 30 minute increment a child was under anesthesia.

The findings will help Institutional Review Boards and parents, who are dealing with the ethics debate around research involving children, evaluate the risk-benefit ratio of proposed studies, particularly those involving prolonged imaging studies.

"Getting a child to remain still in an uncomfortable environment during a procedure, such an MRI or CT scan, where bodily movement undermines the procedure's quality, is a near impossible task, which is why anesthesia is commonly used," Dr. Quezado said. "We know that propofol can be safely administered in pediatric research studies by well-trained anesthesiologists who are prepared to anticipate and respond to all events, which minimizes the risk of adverse issues. We are applying the findings of this research immediately in our own work, and will help others ensure that every study involving children is safe, ethical and effective."

The study reviews 1,480 propofol anesthetics in 607 children over an eight year period at the NIH's Clinical Research Center and appears in the June 7 issue of Archives of Pediatric and Adolescent Medicine. A total of 98 notable events were observed in 63 patients. Only one event led to an escalation of planned therapy. No events led to prolonged hospitalization.

The increased risk related to severity of systemic disease is in concert with clinical studies that show increasingly severe systemic disease is associated with an increased risk for anesthesia related complications, while patients with airway abnormalities are predisposed to airway obstruction.

Dr. Quezado recently joined Children's National Medical Center from NIH. She plays a leading role in the Sheikh Zayed Institute's Pain Medicine Initiative, which aims to improve surgical outcomes through the reduction and elimination of pain. The Institute creates unprecedented opportunities for cross-disciplinary collaborations among leaders from a broad spectrum of sciences, united under one roof to expedite the research into development of more effective treatments.

Team science is often talked about but rarely achieved," Quezado said. "The Institute's balance between clinical and research work and its robust support of truly collaborative partnerships among doctors and scientists, provides tremendous translational research opportunities. That allows us to advance research more quickly and build upon studies like this one, in our ultimate quest to eliminate pain and improve outcomes for children."

Explore further: Mutation may cause early loss of sperm supply

add to favorites email to friend print save as pdf

Related Stories

Acupressure calms children before surgery

Oct 01, 2008

An acupressure treatment applied to children undergoing anesthesia noticeably lowers their anxiety levels and makes the stress of surgery more calming for them and their families, UC Irvine anesthesiologists have learned.

Calming Parents Might Help Kids Cope With Anesthesia

Jul 15, 2009

The start of anesthesia can be distressing for children. Although antianxiety drugs can help keep kids calm, side effects exist. Non-drug methods offer alternatives, but a new review of studies finds that no single method ...

Recommended for you

Mutation may cause early loss of sperm supply

4 minutes ago

Brown University biologists have determined how the loss of a gene in male mice results in the premature exhaustion of their fertility. Their fundamental new insights into the complex process of sperm generation ...

No more bleeding for 'iron overload' patients?

2 hours ago

Hemochromatosis (HH) is the most common genetic disorder in the western world, and yet is barely known. Only in the US 1 in 9 people carry the mutation (although not necessarily the disease).

3-D printing offers innovative method to deliver medication

7 hours ago

3-D printing could become a powerful tool in customizing interventional radiology treatments to individual patient needs, with clinicians having the ability to construct devices to a specific size and shape. That's according ...

Mystery of the reverse-wired eyeball solved

Feb 27, 2015

From a practical standpoint, the wiring of the human eye - a product of our evolutionary baggage - doesn't make a lot of sense. In vertebrates, photoreceptors are located behind the neurons in the back of the eye - resulting ...

Neurons controlling appetite made from skin cells

Feb 27, 2015

Researchers have for the first time successfully converted adult human skin cells into neurons of the type that regulate appetite, providing a patient-specific model for studying the neurophysiology of weight ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.