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在接受磁共振成像检查的儿童中,滴定异丙酚诱导与持续输注的比较。

Titrated propofol induction vs. continuous infusion in children undergoing magnetic resonance imaging.

机构信息

Department of Anaesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Acta Anaesthesiol Scand. 2010 Apr;54(4):453-7. doi: 10.1111/j.1399-6576.2009.02169.x. Epub 2009 Nov 23.

Abstract

BACKGROUND

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).

METHODS

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.

RESULTS

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.

CONCLUSION

A single dose of propofol without a continuous infusion can provide appropriate sedation in children undergoing MRI for <30 min.

摘要

背景

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。

方法

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。

结果

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。

结论

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。

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