Propofol infusion. An alternative for sedation after caudal blockade in children

For the execution of a caudal block in children its necessary that a course of sedatives be given sufficient to maintain sedation throughout the surgical procedure. Many plans of sedation have been employed with the inconvenience of prolonged recovery. This motivated the present work employing propofol, a drug with pharmacokinetic properties that permit rapid recovery, that helps to preserve all the described advantages of the regional anesthesia in children. A study was done in 45 patients, 34 boys and 11 girls classified with ASA 1 and 2. Ages 3 to 108 months, and body weight between 4 and 26 kg, scheduled for elective surgery of the lower abdomen, inguinal channel, and pelvic members, with a duration of the surgery being more than 1 hour. All of the patients received atropine (10 μg/kg) and ketamine (2 mg/kg) intravenously. At the end of the execution of the caudal block, a bolus of IV propofol (1 mg/kg) was administered and continued with infusions of 100, 125, and 150 μg/kg/min, forming 3 different groups A, B, C, respectively. They observed a decrease of the heart rate of 10 and 12% and a decrease of systolic blood pressure of 7 and 10%. All of the patients were breathing spontaneously during the entire procedure, conserving the saturation of oxygen above 96%, with only supplementary oxygen by nasal catheter. The mean time of propofol infusion for group A was 175 ± 70.8 min, for group B was 190.6 + 101.1 min, and for group C was 191.2 + 65.36 min. The recovery time was 6 minutes for group A, 7 minutes for group B, and 6.2 minutes for group C. It has been concluded that a velocity of infusion of 100 μg/kg/min is adequate to maintain sedation without prolonged recovery.