Usher Andrew G, Kearney Ramona A, Tsui Ban C H
Department of Anesthesiology and Pain Medicine, University of Alberta Hospital, Edmonton, Alberta T6G 2B7, Canada.
Paediatr Anaesth. 2005 Jan;15(1):23-8. doi: 10.1111/j.1460-9592.2004.01390.x.
The aim of this study was to assess clinical signs of airway patency, airway intervention requirements and adverse events in 100 children receiving propofol total intravenous anesthesia for magnetic resonance imaging, with spontaneous ventilation and oxygenation via nasal prongs.
Airway patency was clinically assessed and stepwise interventions were performed until a satisfactory airway was achieved. Propofol requirements, vital signs, procedure times and adverse events were also recorded.
Ninety-three per cent of children had no signs of airway obstruction when positioned with a shoulder roll only, two required a chin lift, four required an oral airway and one required lateral positioning. The mean propofol induction dose was 3.9 mg.kg(-1) (range 1.8-6.4 mg.kg(-1)). The mean propofol infusion rate was 193 microg.kg(-1).min(-1) (range 150-250 microg.kg(-1).min(-1)). The initial and final mean respiratory rates were 26 and 23 b.min(-1) (P < 0.05). Movement was more likely at lower infusion rates (mean 175 microg.kg(-1).min(-1)). There were no respiratory or cardiovascular complications (calculated risk: 95% CI = 0-3%). The mean time from end of scan to discharge home was 44 min.
This study demonstrates good preservation of upper airway patency and rapid recovery using general anesthetic doses of propofol in children.
本研究旨在评估100例接受丙泊酚全静脉麻醉进行磁共振成像检查、通过鼻导管自主通气和给氧的儿童的气道通畅临床体征、气道干预需求及不良事件。
对气道通畅情况进行临床评估，并逐步实施干预措施，直至获得满意的气道状态。同时记录丙泊酚需求量、生命体征、检查时间及不良事件。
仅使用肩部垫枕摆放体位时，93%的儿童无气道梗阻体征，2例需要托举下颌，4例需要置入口咽通气道，1例需要侧卧位。丙泊酚诱导剂量平均为3.9 mg·kg⁻¹（范围1.8 - 6.4 mg·kg⁻¹）。丙泊酚输注速率平均为193 μg·kg⁻¹·min⁻¹（范围150 - 250 μg·kg⁻¹·min⁻¹）。初始和最终平均呼吸频率分别为26次/分钟和23次/分钟（P < 0.05）。输注速率较低时（平均175 μg·kg⁻¹·min⁻¹）更易出现体动。未发生呼吸或心血管并发症（计算风险：95%CI = 0 - 3%）。从扫描结束到出院回家的平均时间为44分钟。
本研究表明，儿童使用丙泊酚全麻剂量时，上气道通畅得以良好维持，且恢复迅速。
