Use of Propofol Infusion for Sedation after Pediatric Cardiac Surgery: Propofol Bridge to Tracheal Extubation.

Abstract

Objective: To find out the safety and efficacy of Propofol Infusion as bridge to tracheal extubation after surgeries of
congenital hearts defects in pediatric population.
Methodology: This prospective case series was planned to be conducted at the department of cardiac surgery, National
Institute of Cardiovascular Diseases Karachi; during Jan 2024 to December 2025. It was planned to enroll 50 pediatric
cardiac patients requiring surgery for congenital heart diseases. However, we collected data of 24 patients only who
underwent for palliative or definitive correction of congenital heart defects. Two operated patients; the total Correction of
Tetralogy of Fallot and closure of Ventricular Septal defect respectively developed unexplained increase in the serum
lactate level in the absence of any changes in the hemodynamic. Both patients shared a common factor of having
propofol infusion duration exceeding 8 hours. As the safety of the patient is top most priority, further enrollment was halted.
Results: Our study group included 24 patients, comprising 14 males (58%) and 10 females (42%). Among them, four
patients underwent off-pump surgery, with three receiving palliative shunts and one undergoing PDA ligation. Serum
lactate was monitored hourly for each patient.
Conclusions: Our study raised the concern with Propofol Infusion in pediatric population if used beyond 8 hours.

Key words: Congenital heart defects, Propofol, Tracheal Extubation. Propofol infusion syndrome.