Mallory Michael D, Baxter Amy L, Kost Susanne I
Pediatric Sedation Services, Children's Healthcare of Atlanta at Scottish Rite Hospital, Atlanta, GA, USA.
Paediatr Anaesth. 2009 Jun;19(6):601-11. doi: 10.1111/j.1460-9592.2009.03023.x.
Pentobarbital and propofol are commonly used to sedate children undergoing magnetic resonance imaging (MRI). The Pediatric Sedation Research Consortium (PSRC) was created in 2003 to improve pediatric sedation process and outcomes.
To use PSRC records to compare the effectiveness, efficiency and adverse events of propofol vs pentobarbital for sedation of children undergoing MRI.
Pediatric Sedation Research Consortium records of children aged 6 months to 6 years who were primarily sedated with either i.v. pentobarbital or propofol were included. Participating PSRC investigators obtained institutional review board approval before data collection.
Of 11 846 sedations for MRI, 7079 met inclusion criteria (propofol: n = 5072; pentobarbital: n = 2007). Demographic details were similar between the two groups. Ideal sedation was produced in 96.45% of the pentobarbital group and in 96.8% of the propofol group (P = 0.478), but pentobarbital was more likely to result in poor sedation cancelling the procedure (OR 5.88; CI 2.24, 15.40). Propofol resulted in physiologic changes more frequently than did pentobarbital (OR 5.69; CI 1.35, 23.97). Pentobarbital was associated with prolonged recovery (OR 16.82; CI 4.98, 56.8), unplanned admission (OR 5.60; CI 1.02, 30.82), vomiting (OR 36.76; CI 4.84, 279.2) and allergic complication (OR 9.15; CI 1.02, 82.34). The incidence of airway complications was not significantly different between the two. The median recovery time for patients receiving propofol was 30 min, whereas for pentobarbital it was 75 min (P < 0.001).
Among institutions contributing data to the PSRC, it is found that propofol provides more efficient and effective sedation than pentobarbital for children undergoing MRI. Although apnea occurred with a greater frequency in patients who received propofol, the rate of apnea and airway complications for propofol was not statistically different from that seen in patients who received pentobarbital.
戊巴比妥和丙泊酚常用于为接受磁共振成像（MRI）检查的儿童进行镇静。儿科镇静研究联盟（PSRC）于2003年成立，旨在改善儿科镇静流程及效果。
利用PSRC的记录，比较丙泊酚与戊巴比妥在为接受MRI检查的儿童进行镇静时的有效性、效率及不良事件。
纳入PSRC中年龄在6个月至6岁、主要通过静脉注射戊巴比妥或丙泊酚进行镇静的儿童记录。参与研究的PSRC研究人员在收集数据前获得了机构审查委员会的批准。
在11846例MRI镇静病例中，7079例符合纳入标准（丙泊酚组：n = 5072；戊巴比妥组：n = 2007）。两组的人口统计学细节相似。戊巴比妥组96.45%、丙泊酚组96.8%达到理想镇静效果（P = 0.478），但戊巴比妥更易导致镇静效果不佳而取消检查（比值比5.88；可信区间2.24, 15.40）。丙泊酚比戊巴比妥更频繁地引起生理变化（比值比5.69；可信区间1.35, 23.97）。戊巴比妥与恢复时间延长（比值比16.82；可信区间4.98, 56.8）、非计划住院（比值比5.60；可信区间1.02, 30.82）、呕吐（比值比36.76；可信区间4.84, 279.2）及过敏并发症（比值比9.15；可信区间1.02, 82.34）相关。两组气道并发症的发生率无显著差异。接受丙泊酚的患者中位恢复时间为30分钟，而接受戊巴比妥的患者为75分钟（P < 0.001）。
在向PSRC提供数据的机构中，发现丙泊酚在为接受MRI检查的儿童进行镇静时比戊巴比妥更高效、有效。尽管接受丙泊酚的患者呼吸暂停发生率更高，但丙泊酚的呼吸暂停及气道并发症发生率与接受戊巴比妥的患者相比无统计学差异。
