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Ann Emerg Med. 2007 Jan;49(1):9-13. Epub 2006 Aug 17.

Capnography and depth of sedation during propofol sedation in children.

Author information

1
Division of Pediatric Emergency Medicine, University of Utah, Salt Lake City, UT, USA. jana.anderson@hsc.utah.edu

Abstract

STUDY OBJECTIVE:

To evaluate the relationship between continuous capnography and observed airway and respiratory adverse effects and the depth of sedation when using propofol for pediatric orthopedic procedures.

METHODS:

We administered propofol after opioid premedication in a prospective convenience sample of children undergoing orthopedic reduction in our emergency department (ED). All children received supplemental oxygen (1 L/minute by nasal cannula) and continuous capnography and had depth of sedation assessed every 2 minutes. Adverse airway or respiratory events and any associated interventions were recorded.

RESULTS:

Adverse airway or respiratory events with intervention occurred in 14 of the 125 enrolled children (11%; 95% confidence interval 4.0% to 14%): jaw thrust in 4, supplemental oxygen in 6, and bag-valve-mask ventilation in 4. All interventions required were brief (<30 seconds). Capnography detected apnea before clinical examination or pulse oximetry in all 5 occurrences and similarly first detected airway obstruction in 6 of the 10 occurrences. The median maximal modified Ramsay score was 6 (range 3 to 8), ie, deep sedation.

CONCLUSION:

When propofol is administered for ED deep sedation to facilitate pediatric orthopedic reduction, continuous capnography detects most airway and respiratory events leading to intervention before clinical examination or pulse oximetry.

[Indexed for MEDLINE]

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