Punj Jyotsna, Bhatnagar Sushma, Saxena Abha, Mishra Seema, Kannan T R, Panigrahi Manas, Pandey Vipin
Unit of Anesthesiology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi.
Indian J Pediatr. 2002 Jun;69(6):495-9. doi: 10.1007/BF02722651.
Pediatric radiotherapy is a day care procedure. In children, anaesthesia is necessary to prevent movement during the therapy. Traditionally intramuscular ketamine is used for these procedure because of its inherent safety in a child who used to be left alone in the cobalt room.
This study was designed to explore the efficacy of propofol and ketamine in pediatric radiotherapy in nineteen children. The inclusion criteria was a child fasting for six hours with no fever or URTI in the past week. A child coming to the radiotherapy (RT) unit without an intravenous cannula was given intramuscular ketamine 10 mg/kg and taken for the procedure. Before the child recovered from anaesthesia an intravenous cannula, 20-22G, Vasofix was inserted for subsequent sittings of RT. The child coming with an intravenous cannula was given propofol 2.5 mg/kg with xylocaine (0.1 mg/kg) without adrenaline. The parameters recorded were pulse rate, oxygen saturation and respiratory rate-baseline to every 30 seconds till five minutes. Onset time, recovery time, oral feeding time and any untoward effects like nausea, vomiting, nystagmus were also noted.
The drug was graded on a scale of 0-10 according to parental acceptability where 0 is the worst and 10 is the best acceptability. The mean (+/-SD) of all the measured parameters were calculated and compared between the two groups.
Propofol was associated with faster onset, better recovery, early oral feeding time, no nausea and vomiting and better parental acceptability. There was no hypotension, bradycardia and oxygen saturation at 60 seconds, which was between 94-95%, was easily treatable with supplementation of oxygen by face mask.
儿科放射治疗是一种日间护理程序。对于儿童,麻醉是防止治疗过程中移动所必需的。传统上,肌肉注射氯胺酮用于这些程序,因为它在过去常被留在钴室的儿童中具有内在安全性。
本研究旨在探讨丙泊酚和氯胺酮在19名儿童儿科放射治疗中的疗效。纳入标准为儿童禁食6小时,且过去一周无发热或上呼吸道感染。未插静脉套管前来放射治疗(RT)科的儿童肌肉注射10mg/kg氯胺酮后接受治疗。在儿童从麻醉中恢复前,插入一根20 - 22G的Vasofix静脉套管,以备后续RT治疗。已插静脉套管前来的儿童给予2.5mg/kg丙泊酚加利多卡因(0.1mg/kg),不加肾上腺素。记录的参数包括脉搏率、血氧饱和度和呼吸频率——从基线开始每30秒记录一次,直至5分钟。还记录了起效时间、恢复时间、经口进食时间以及任何不良影响,如恶心、呕吐、眼球震颤。
根据家长可接受程度,药物按0 - 10分进行评分,0分为最差可接受程度,10分为最佳可接受程度。计算两组所有测量参数的平均值(±标准差)并进行比较。
丙泊酚起效更快、恢复更好、经口进食时间更早、无恶心呕吐且家长可接受程度更高。未出现低血压、心动过缓,60秒时血氧饱和度在94% - 95%之间,通过面罩吸氧很容易处理。