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AMBULATORY ANESTHESIA

The Clinical and Biochemical Effects of Propofol Infusion With and Without EDTA for Maintenance Anesthesia in Healthy Children Undergoing Ambulatory Surgery

Ira T. Cohen, MD^*, Raafat S. Hannallah, MD^*, and David B. Goodale, DDS, PhD

*Departments of Anesthesiology and Pediatrics, Children’s National Medical Center and George Washington University Medical Center, Washington, DC; and AstraZeneca Pharmaceuticals, Wilmington, Delaware

Address correspondence and reprint requests to Raafat S. Hannallah, MD, Professor of Anesthesiology and Pediatrics, George Washington University Medical Center, Chairman of Anesthesiology, Children’s National Medical Center, 111 Michigan Ave., N.W., Washington, DC 20010.

We conducted this randomized, double-blinded, comparative, parallel-group study to determine whether adding EDTA to propofol would affect the clinical profile, calcium and magnesium homeostasis, or renal function in healthy children. After the induction of anesthesia with halothane, 69 ambulatory surgical patients (1 mo to <17 yr old), received propofol without EDTA (n = 33) or propofol with EDTA (n = 36). Blood samples were obtained for the measurement of ionized calcium, ionized magnesium, and laboratory indicators of renal function. Hemodynamic measurements, recovery, and adverse events were recorded. Propofol with EDTA produced no significant effects on clinical efficacy or renal function. Propofol and propofol EDTA produced a statistically significant decrease from baseline in serum concentrations of ionized calcium and magnesium during infusion (P<0.05), but with no apparent clinical effect. Hemodynamic measurements generally remained stable and were similar for both groups. Statistically significant changes in systolic blood pressure, mean arterial pressure, and heart rate were not considered clinically significant. Adverse events were mild or moderate. The addition of EDTA does not alter the clinical profile of propofol in pediatric ambulatory surgical patients. With or without EDTA, propofol is associated with a decrease in ionized calcium with no apparent clinical effect.

Implications: The addition of EDTA does not alter the clinical profile of propofol inpediatric ambulatory surgical patients. With or without EDTA, propofol isassociated with a decrease in ionized calcium with no apparent clinicaleffect.

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