{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:42:53Z","timestamp":1753879373482,"version":"3.41.2"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,10,7]],"date-time":"2023-10-07T00:00:00Z","timestamp":1696636800000},"content-version":"vor","delay-in-days":279,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Children receiving proton therapy require repeated sedation. In this study, we aimed to investigate the utility of the perfusion index (PI) for evaluating consciousness level during repeated propofol sedation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective observational study, children aged from birth to 19\u2009years old scheduled for proton therapy under repeated propofol sedation were enrolled. The primary outcome was the equivalence of PI values 5\u2009min after anesthesia induction on consecutive sedation. Total consumption of propofol during sedation, time to reach the University of Michigan sedation scale (UMSS) score 1 after end of proton therapy, and duration of post\u2010anesthesia care unit (PACU) stay were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The PI values measured 5\u2009min after induction of anesthesia were not equivalent to each other in consecutive sedation except for the second versus third (1st vs. 2nd: 97.5% CI: \u22121.34, 0.91; <jats:italic>p<\/jats:italic>\u2009=\u20090.206, 0.034; 2nd vs. 3rd: 97.5% CI: \u22120.87, 0.94; <jats:italic>p<\/jats:italic>\u2009=\u20090.023, 0.036 3rd vs. 4th: 97.5% CI: \u22122.08, \u22120.26; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.99, &lt;0.001; 4th vs. 5th: 97.5% CI: 0.21, 2.28; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, &gt;0.99; respectively). In consecutive sedation, there was not a significantly different difference in the time to reach UMSS score 1 (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.99, all) for total consumption of propofol, time to reach UMSS score 1 after the end of proton therapy, and duration of PACU stay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>During repeated propofol sedation in children, PI was insufficient to be used as an indicator of consciousness level assessment. However, we suggest that the information related to repeated sedation provided by this study may be helpful in clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.15659","type":"journal-article","created":{"date-parts":[[2023,10,7]],"date-time":"2023-10-07T07:41:26Z","timestamp":1696664486000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The utility of the perfusion index as an indicator of anesthetic depth for repeated propofol sedation in children: An observational study"],"prefix":"10.1111","volume":"65","author":[{"given":"Doyeon","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center CHA University School of Medicine  Seongnam Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jisu","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nam\u2010Su","family":"Gil","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung Yeon","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young Ri","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin 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