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<p>Propofol total intravenous anesthesia (TIVA) is increasingly used in pediatric practice, but concerns persist regarding delayed emergence after prolonged infusions due to its context-sensitive half-time and interindividual variability in pharmacokinetics and pharmacodynamics, especially in younger children with immature pharmacokinetic profiles. This prospective study was conducted at a tertiary university hospital between August 2022 and June 2023. We enrolled 47 children aged 12 months to 15 years undergoing elective surgery lasting ≥ 120&#xa0;min who received target-controlled infusion (TCI) of propofol using the Paedfusor model. Patients were stratified into four age groups: 12–23 months, 2–6 years, 7–11 years, and 12–15 years. The primary outcome was extubation time. Secondary outcomes included total propofol requirements and BIS less than 30. Extubation times did not differ significantly among groups (mean 12.1–17.8&#xa0;min; ANOVA <i>p</i> &gt; 0.05) and demonstrated statistical equivalence across age groups (all pairwise differences within ± 10&#xa0;min). Neither age nor propofol dose predicted extubation time (R² = 0.052, <i>p</i> = 0.314). Propofol requirements decreased significantly with age (Spearman’s <i>r</i> = − 0.80, <i>p</i> &lt; 0.0001), while Ce at first purposeful movement converged across groups (1.9–2.3&#xa0;µg/mL). In pediatric patients undergoing medium-duration surgery with propofol-based TCI anesthesia, extubation times were comparable across age groups despite higher propofol requirements in younger children. A nonsignificant trend toward more delayed extubation was observed in the youngest subgroups, which should be interpreted with caution given the small sample sizes.</p>

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Age-related differences in extubation time following propofol-based target-controlled infusion in pediatric medium-duration surgery: A prospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月18日

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  • Issada Jindawatthana,
  • Patcharee Sriswasdi,
  • Wiriya Maisat,
  • Pawana Yonphan,
  • Saowaphak Lapmahapaisan

摘要

Propofol total intravenous anesthesia (TIVA) is increasingly used in pediatric practice, but concerns persist regarding delayed emergence after prolonged infusions due to its context-sensitive half-time and interindividual variability in pharmacokinetics and pharmacodynamics, especially in younger children with immature pharmacokinetic profiles. This prospective study was conducted at a tertiary university hospital between August 2022 and June 2023. We enrolled 47 children aged 12 months to 15 years undergoing elective surgery lasting ≥ 120 min who received target-controlled infusion (TCI) of propofol using the Paedfusor model. Patients were stratified into four age groups: 12–23 months, 2–6 years, 7–11 years, and 12–15 years. The primary outcome was extubation time. Secondary outcomes included total propofol requirements and BIS less than 30. Extubation times did not differ significantly among groups (mean 12.1–17.8 min; ANOVA p > 0.05) and demonstrated statistical equivalence across age groups (all pairwise differences within ± 10 min). Neither age nor propofol dose predicted extubation time (R² = 0.052, p = 0.314). Propofol requirements decreased significantly with age (Spearman’s r = − 0.80, p < 0.0001), while Ce at first purposeful movement converged across groups (1.9–2.3 µg/mL). In pediatric patients undergoing medium-duration surgery with propofol-based TCI anesthesia, extubation times were comparable across age groups despite higher propofol requirements in younger children. A nonsignificant trend toward more delayed extubation was observed in the youngest subgroups, which should be interpreted with caution given the small sample sizes.