Clinical evaluation of propofol as sedative for endotracheal intubation in neonates

Acta Paediatr. 2013 Nov;102(11):e487-92. doi: 10.1111/apa.12367. Epub 2013 Aug 27.


Aim: To determine the effects of propofol for endotracheal intubation in neonates in daily clinical practice.

Methods: We prospectively studied the pharmacodynamic effects of intravenous propofol administration in neonates who needed endotracheal intubation at the neonatal intensive care unit.

Results: Propofol was used for 62 intubations in neonates with postmenstrual ages ranging from 24 + 3 weeks to 44 + 5 weeks and bodyweights ranging from 520 to 4380 g. A 2 mg/kg bodyweight propofol starting dose was sufficient in 37% of patients; additional propofol was needed less often on the first postnatal day. The mean amount of propofol used was 3.3 (±1.2) mg/kg. The success rate of intubation depended on the experience of the physician and was related to the total administered amount of propofol. Hypotension occurred in 39% of patients and occurred more often at the first postnatal day. In 15% of procedures, propofol mono therapy was insufficient.

Conclusion: This study shows that high doses of propofol are needed to reach effective sedation in neonates for intubation, with hypotension as a side effect in a considerable percentage of patients. Further research in newborn patients needs to identify optimal propofol doses and risk factors for hypotension.

Keywords: Intubation; Neonatology; Propofol; Sedation.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anesthetics, Intravenous / administration & dosage*
  • Anesthetics, Intravenous / adverse effects
  • Humans
  • Hypotension / chemically induced
  • Infant, Newborn*
  • Intensive Care, Neonatal*
  • Intubation, Intratracheal*
  • Propofol / administration & dosage*
  • Propofol / adverse effects
  • Prospective Studies


  • Anesthetics, Intravenous
  • Propofol