Ellen de Kort

137 Blood pressure after propofol in neonates 8 Secondary outcome measures Changes in MBP in relation to hemodynamic status For this analysis we included 69 patients of whom sufficient data regarding baseline MBP and MBP in the first hour after propofol were available. The results of the analysis are presented in Table 3. The incidence of hypotension was, as expected, significantly higher in group 2, and the lowest MBP after start of propofol was significantly lower in this group. The incidence of hypotension, the lowest MBP after start of propofol and the maximum decrease in MBP after propofol were equal between group 1 and group 3. Changes in MBP in relation to cumulative propofol dose Independent of the propofol starting doses that were administered, we also analyzed the average change in MBP over time for different cumulative doses of propofol, independent of the propofol starting dose. The results of this analysis are shown in Table 4. In all cumulative doses, MBP significantly declined compared to baseline, with the largest declines in the 1.0 and 2.5 mg/kg cumulative doses. These results have to be interpreted with some caution because of the small patient numbers, but could indicate that the cumulative dose of propofol did not influence the decline in MBP after propofol. Table 4. MBP changes in different cumulative propofol doses Cumulative propfol dose Change in MBP relative to baseline 95% Confidence interval p-value 1 mg/kg -8.9 -12.8 -5.0 <0.001 1.5 mg/kg -4.8 -8.8 -0.9 0.02 2 mg/kg -2.8 -5.2 -0.4 0.02 2.5 mg/kg -9.4 -14.7 -4.2 <0.001 3 mg/kg -4.9 -7.6 -2.3 <0.001 ≥ 3.5 mg/kg -4.3 -6.7 -1.8 0.001 DISCUSSION This post-hoc analysis was performed to explore the effects of different propofol starting doses as premedication for endotracheal intubation on blood pressure. The results of this analysis show that propofol starting doses of 1.0 mg/kg, 1.5 mg/kg and 2.0 mg/kg all caused a profound and prolonged decline in blood pressure. In all three dosing groups, MBP decreased by a maximum of 30%-35% in comparison with the baseline MBP, and MBP was not restored after one hour. The decrease in blood pressure was most pronounced with a propofol starting dose of 2.0 mg/kg.