Koroglu Ahmet, Teksan Huseyin, Sagir Ozlem, Yucel Aytaç, Toprak Huseyin I, Ersoy Ozcan M
Department of Anesthesiology and Reanimation, Inonu University, Medical Faculty, 44315 Malatya, Turkey.
Anesth Analg. 2006 Jul;103(1):63-7, table of contents. doi: 10.1213/01.ANE.0000219592.82598.AA.
We compared the sedative, hemodynamic, and respiratory effects of dexmedetomidine and propofol in children undergoing magnetic resonance imaging procedures. Sixty children were randomly distributed into two groups: The dexmedetomidine (D) group received 1 microg/kg initial dose followed by continuous infusion of 0.5 microg.kg(-1).h(-1) and a propofol group (P) received 3 mg/kg initial dose followed by a continuous infusion of 100 microg.kg(-1).min(-1). Inadequate sedation was defined as difficulty in completing the procedure because of the child's movement during magnetic resonance imaging. Mean arterial pressure (MAP), heart rate, peripheral oxygen saturation, and respiratory rate (RR) were recorded during the study. The onset of sedation, recovery, and discharge time were significantly shorter in group P than in group D. MAP, heart rate, and RR decreased during sedation from the baseline values in both groups. MAP and RR were significantly lower in group P than in group D during sedation. Desaturation was observed in four children of group P. Dexmedetomidine and propofol provided adequate sedation in most of the children. We conclude that although propofol provided faster anesthetic induction and recovery times, it caused hypotension and desaturation. Thus, dexmedetomidine could be an alternative reliable sedative drug to propofol in selected patients.
我们比较了右美托咪定和丙泊酚在接受磁共振成像检查的儿童中的镇静、血流动力学及呼吸效应。60名儿童被随机分为两组：右美托咪定（D）组先给予1μg/kg的初始剂量，随后以0.5μg·kg⁻¹·h⁻¹的速度持续输注；丙泊酚组（P）先给予3mg/kg的初始剂量，随后以100μg·kg⁻¹·min⁻¹的速度持续输注。镇静不足被定义为因儿童在磁共振成像过程中的活动而导致检查难以完成。研究期间记录平均动脉压（MAP）、心率、外周血氧饱和度及呼吸频率（RR）。P组的镇静起效、恢复及出院时间显著短于D组。两组在镇静期间MAP、心率及RR均较基线值下降。P组在镇静期间MAP及RR显著低于D组。P组有4名儿童出现了血氧饱和度下降。右美托咪定和丙泊酚在大多数儿童中均提供了充分的镇静。我们得出结论，尽管丙泊酚提供了更快的麻醉诱导和恢复时间，但它会导致低血压和血氧饱和度下降。因此，在特定患者中，右美托咪定可能是丙泊酚的一种可靠替代镇静药物。
