Evaluation of Propofol Anesthesia in Morbidly Obese Children and Adolescents

Vidya Chidambaran; Senthilkumar Sadhasivam; Jeroen Diepstraten; Hope Esslinger; Shareen Cox; Beverly M Schnell; Paul Samuels; Thomas Inge; Alexander A Vinks; Catherijne A Knibbe


BMC Anesthesiol. 2013;13(8) 

In This Article


In conclusion, this study presents a detailed descriptive analysis of propofol anesthesia in MO adolescents. Although BIS has been found to improve clinically important outcomes in children undergoing inhalation anesthesia,[29] it is not a standard monitor in paediatric anesthetic practice. In MO adults, La Colla et. al. concluded that it is advisable to administer propofol to MO patients by titration to targeted processed-EEG values.[30] Our findings suggest that in the absence of evidence based dosing guidelines for propofol administration in this MO paediatric population, use of only clinical parameters to dose TIVA with propofol can result in excessive depth of anesthesia. In this setting, BIS monitoring provides anesthesiologists information about real time trend of anesthetic depth and helps prevent excessive propofol administration and associated negative consequences. Our findings also emphasize the need for improved propofol dosing guidelines and monitoring during TIVA in MO adolescents to minimize relative overdosing and its negative consequences.