Age-related differences in extubation time following propofol-based target-controlled infusion in pediatric medium-duration surgery: A prospective cohort study
- 1Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University
Abstract
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.
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BibTeX
@article{jindawatthana2026agerelated,
title = {{Age-related differences in extubation time following propofol-based target-controlled infusion in pediatric medium-duration surgery: A prospective cohort study}},
author = {Issada Jindawatthana and Patcharee Sriswasdi and Wiriya Maisat and Pawana Yonphan and Saowaphak Lapmahapaisan},
journal = {Scientific Reports},
year = {2026},
month = jul,
doi = {10.1038/s41598-026-62636-7},
url = {https://doi.org/10.1038/s41598-026-62636-7},
note = {CC BY},
}
RIS
TY - JOUR
TI - Age-related differences in extubation time following propofol-based target-controlled infusion in pediatric medium-duration surgery: A prospective cohort study
AU - Issada Jindawatthana
AU - Patcharee Sriswasdi
AU - Wiriya Maisat
AU - Pawana Yonphan
AU - Saowaphak Lapmahapaisan
PY - 2026
DA - 2026/07/01
JO - Scientific Reports
DO - 10.1038/s41598-026-62636-7
UR - https://doi.org/10.1038/s41598-026-62636-7
AB - 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.
SN - 2045-2322
ER -