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KMID : 0878620010050020069
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Korean Journal of Pediatric Anesthesia
2001 Volume.5 No. 2 p.69 ~ p.73
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Propofol and Involuntary Movements in Children: The Slower the Injection Rate, the More the Movement
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Kil Hae-Keum
Kim Won-Oak
Cho Jang-Eun
Jung Joo-Yung
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Abstract
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Background: Although the proconvulsant or anticonvulsant properties of propofol remain a matter of controversy, it is evident that propofol can produce an involuntary movement. Such involuntary movement is a relatively common side effect, especially in children, and may be dose/injection rate-related. The goal of this study was to evaluate the effect of injection rate upon involuntary movement during propofol induction in children.
Methods: Children (age 3∼14 yr) undergoing elective Eye and ENT surgery were randomly allocated to three groups based on propofol injection rate (A, 360㎖/hr; B, 200㎖/hr; C, 100㎖/hr). No premedication was used. The induction dosage of propofol was 3㎎/㎏ in all groups. Fentanyl and lidocaine were injected before propofol. Involuntary movements were graded 0∼2 on severity. Movement due to pain or mask fitting was not regarded as an involuntary movement. All results were analyzed using Chi-Square-Test and ANOVA.
Results: 422 children were studied. Age, gender, and weight were similar in three groups. Involuntary movements were apparent in 160 (36.2%) of 422 subjects. Movements were significantly less in group A (16.4%) than in group B (46.6%) and C (45.3%). The mean grade and duration of movement were similar in three groups. Movements were common in age 7∼10 yr and no differences were found between gender.
Conclusions: We concluded that slow propofol injection may increase the incidence of involuntary movement. Since the injection rate in bolus most of syringe pumps is usually slow, manual injection may be a better choice for smoother induction in children.
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KEYWORD
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Anesthetics, intravenous: propofol, Complication: movement
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