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

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Abstract
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.

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