Department of Anaesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.
Acta Anaesthesiol Scand. 2010 Apr;54(4):453-7. doi: 10.1111/j.1399-6576.2009.02169.x. Epub 2009 Nov 23.
Propofol is the popular intravenous (i.v.) anaesthetic for paediatric sedation because of its rapid onset and recovery. We compared the efficacy and safety of a single dose and conventional infusion of propofol for sedation in children who underwent magnetic resonance imaging (MRI).
This was a double-blind, randomized-controlled study. One hundred and sixty children were assigned to group I (single dose) or II (infusion). Sedation was induced with i.v. propofol 2 mg/kg, and supplemental doses of propofol 0.5 mg/kg were administered until adequate sedation was achieved. After the induction of sedation, we treated patients with a continuous infusion of normal saline at a rate of 0.3 ml/kg/h in group I and the same volume of propofol in group II. In case of inadequate sedation, additional propofol 0.5 mg/kg was administered and the infusion rate was increased by 0.05 ml/kg/h. Induction time, sedation time, recovery time, additional sedation and adverse events were recorded.
Recovery time was significantly shorter in group I compared with group II [0 (0-3) vs. 1 (0-3), respectively, P<0.001]. Group I (single dose) had significantly more patients with recovery time 0 compared with group II (infusion) (65/80 vs. 36/80, respectively, P<0.001). Induction and sedation times were not significantly different between groups. There was no significant difference in the frequency of additional sedation and adverse events between groups.
A single dose of propofol without a continuous infusion can provide appropriate sedation in children undergoing MRI for <30 min.
丙泊酚是儿科镇静的常用静脉（i.v.）麻醉剂，因为它具有起效快和恢复快的特点。我们比较了单次剂量和常规输注丙泊酚在接受磁共振成像（MRI）的儿童镇静中的疗效和安全性。
这是一项双盲、随机对照研究。将 160 名儿童分为 I 组（单次剂量）或 II 组（输注）。静脉注射丙泊酚 2 mg/kg 诱导镇静，给予 0.5 mg/kg 的补充剂量，直到达到适当的镇静水平。镇静诱导后，I 组以 0.3 ml/kg/h 的速度给予生理盐水持续输注，II 组给予相同体积的丙泊酚。如果镇静不足，给予额外的 0.5 mg/kg 丙泊酚，并将输注速度增加 0.05 ml/kg/h。记录诱导时间、镇静时间、恢复时间、额外镇静和不良事件。
与 II 组相比，I 组的恢复时间明显缩短[分别为 0（0-3）与 1（0-3），P<0.001]。与 II 组（输注）相比，I 组（单次剂量）有更多的患者恢复时间为 0[分别为 65/80 与 36/80，P<0.001]。两组诱导和镇静时间无显著差异。两组间额外镇静和不良事件的发生率无显著差异。
在 MRI 检查时间<30 分钟的儿童中，不进行持续输注的单次丙泊酚剂量可以提供适当的镇静。
