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- Title
Propofol in preterm neonates.
- Authors
Meyer, Sascha; Bay, Johannes; Poryo, Martin
- Abstract
Conversely, in their initial analysis, De Kort et al. showed that a propofol starting dose of 2.0 mg/kg provided effective sedation in 86% of patients, compared to 13% and 4% of the patients who received a starting dose of 1.5 mg/kg or 1.0 mg/kg, respectively.2 We would like to comment on three aspects of their study. Dear Sir, In their prospepective study in very preterm neonates, De Kort et al. analysed the effects of different propofol starting doses as premedication for endotracheal intubation on blood pressure (1.0 mg/kg ( I n i = 30), 1.5 mg/kg ( I n i = 23) or 2.0 mg/kg ( I n i = 26)).1 The authors demonstrated that propofol caused a dose-dependent profound and protracted drop in blood pressure which was mainly dependent on the initial propofol starting dose rather than the cumulative propofol dose. However, previous studies have shown substantial intraindividual variability in propofol dosage in children.4 Thus, we agree with De Kort et al. that by titrating propofol until the desired level of sedation has been achieved, adverse effects (eg arterial hypotension) may be minimised.1,4 However, it is also important to note that previous reports indicated that propofol may exert pro-convulsant activities when given in subanaesthetic doses, while higher doses may have anti-convulsant activities.5 Unfortunately, De Kort et al. did not specifically mention the occurrence of seizure-like phenomena or frank seizure activity in their cohort,1,2 adverse events that have been linked to propofol.
- Subjects
PROPOFOL; NEURODEVELOPMENTAL treatment for infants; NEWBORN infants
- Publication
Acta Paediatrica, 2021, Vol 110, Issue 5, p1692
- ISSN
0803-5253
- Publication type
Article
- DOI
10.1111/apa.15759