TY - CHAP M1 - Book, Section TI - Hypnotics A1 - Amin, Sapan A2 - Ellinas, Herodotos A2 - Matthes, Kai A2 - Alrayashi, Walid A2 - Bilge, Aykut Y1 - 2021 N1 - T2 - Clinical Pediatric Anesthesiology AB - FOCUS POINTSBody composition is different in children than in adults, with children having a higher proportion of total body water than fat and muscle.Egg allergy does not preclude propofol use (egg lecithin) because the usual allergy is due to egg albumin.Prolonged propofol infusions (24 hours) can lead to propofol infusion syndrome (PRIS), which is a syndrome defined by metabolic acidosis, rhabdomyolysis, lipemia, and hepatomegaly.Among the hypnotics, only ketamine has both amnestic and analgesic properties and is considered the most complete anesthetic.Ketamine should be used with caution in patients that are sympathetically depleted (ICU patients) because it has direct myocardial depressant effects.Etomidate provides hemodynamic stability upon administration but can cause adrenal insufficiency even after a single dose.Midazolam is the most common premedication in adults intravenously, and in children orally.Methohexital can be used for maintenance of anesthesia instead of propofol in patients with mitochondrial disorders. It should be used with caution in patients with seizure history. SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/04/19 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1176457032 ER -