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British Journal of Anaesthesia, 1992, Vol. 69, No. 6 570-576
© 1992 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

PROPOFOL AND ALFENTANIL IN CHILDREN: INFUSION TECHNIQUE AND DOSE REQUIREMENT FOR TOTAL I.V. ANAESTHESIA

B. L. BROWNE, M.B., B.CH., B.SC., F.R.C.ANAES.*, C. PRYS-ROBERTS, M.A., D.M., PH.D., F.R.C.ANAES., F.A.N.Z.C.A.1 and A. R. WOLF, M.A., M.B., B.CHIR., F.R.C.ANAES.{dagger}

Sir Humphry Davy Department of Anaesthesia, Bristol Royal Infirmary Bristol BS2 8HW

1 Correspondence to C.P.-R., Bristol.

We estimated the dose of propofol (initial dose followed by a stepped infusion) when given with two different infusion rates of alfentanil for total i. v. anaesthesia in 59 children aged 3–12 yr. Patients in series 1 (four groups) received an alfentanil loading dose of 85g kg–1 and an infusion of 65 g kg–1 h–1. Patients in series 2 (groups 5 and 6) received an alfentanil loading dose of 65 g kg–1 and infusion of 50 g kg–1 h–1. Parents gave their informed consent. Premedication comprised temazepam 0.3 mg kg–1. Glycopyrronium 5 g kg–1 was administered and anaesthesia induced and maintained with alfentanil (loading dose and infusion) followed by propofol (loading dose and three-stage manual infusion scheme). Suxa-methonium 1 mg kg–1 was used to facilitate tracheal intubation and the lungs were ventilated artificially to normocapnia with 30% oxygen in air. Probit analysis was used to determine the dose requirement of propofol. In series 1. the ED50 was 6.0 mg kg–1 h–1 (95% confidence limits 5.5-6.2 mg kg–1 h–1) and ED95 8.6 (6.8-7.8) mg kg–1 h–1. Corresponding values for series 2 were ED50 7.5 (8.0-9.8) mg kg–1 h–1 and ED95 10.5 (9.6–13.1) mg kg–1h–1.

*Department of Anaesthesia, University of Newcastle upon Tyne, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP.

{dagger}Department of Anesthesiology, College of Medicine, The Pennsylvania State University, P.O. Box 850, Hershey Pennsylvania, U.S.A. 17033.


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