Propofol anesthesia for elective cardioversion of pediatric intensive care unit patients with congenital heart disease

Propofol is an intravenous sedative-hypnotic anesthetic agent that has been increasingly employed to facilitate elective direct current cardioversion in adult patients. Little information is available about use of propofol in pediatric intensive care unit patients with congenital heart disease undergoing elective cardioversion. We report our experience with 33 cardioversions performed in our pediatric intensive care unit using propofol anesthesia. Propofol provided good subjective conditions for cardioversion in all patients, and 97% of cardioversions successfully converted atrial flutter into a sinus rhythm. Mean induction time was 5.97 +/- 3.54 minutes, and recovery time was 28.08 +/- 22.88 minutes. Length of stay in the pediatric intensive care unit was 3.84 +/- 1.20 hours. Transient hypotension occurred during 24% of cardioversions, whereas brief periods of respiratory depression were present during 30% of cardioversions, Propofol anesthesia can be successfully administered during elective cardioversion in pediatric intensive care unit patients with congenital heart disease provided that appropriate cardiorespiratory monitoring and supportive therapies are in place.