Division of Pediatric Critical Care and Sedation Service, Helen DeVos Children's Hospital, Grand Rapids, MI, USA.
Pediatr Crit Care Med. 2011 Nov;12(6):e262-5. doi: 10.1097/PCC.0b013e31820ab881.
Intermittent bolus propofol is an effective agent for pediatric magnetic resonance imaging sedation but requires constant vigilance and dose titration. Magnetic resonance imaging-compatible infusion pumps may make it possible to continuously infuse propofol, achieving a steady level of sedation at a lower total dose. This study investigates total propofol dose, recovery time, and magnetic resonance image quality in children receiving intermittent vs. continuously infused propofol sedation in children undergoing brain and spine magnetic resonance imaging studies.
An open-label, prospective, randomized, controlled study. A single-blinded radiologist rated the quality of magnetic resonance images.
Children's hospital pediatric radiology sedation center.
One hundred seventy children age 1 month to 18 yrs undergoing deep sedation for brain, spine, or both brain and spine magnetic resonance imaging.
After informed consent, patients were randomly assigned to two groups: group 1 (intermittent) received a propofol bolus of 2-4 mg/kg, followed by repeat boluses of 0.5-2 mg/kg/dose as needed. Group C (continuous) received a bolus of propofol 2-4 mg/kg, followed by a continuous infusion of 100 μg/kg/min with 1-mg/kg/dose boluses with drip titration to effect.
Patient demographics, sedation risk assessment, propofol dose, sedation recovery times, incidence of complications, and quality of the magnetic resonance imaging studies were measured. A total of 170 children were enrolled in the study, with 75 in group C and 95 in group I. Both groups were similar with regard to age, weight, gender, and magnetic resonance imaging study type. Group C required a lesser dose of propofol (132 ± 54 μg/kg/min) compared to (162 ± 74 μg/kg/min) in that required in group I (p = .018). There were no differences between the two groups with regard to quality of the imaging study, recovery time, or incidence of complications.
Compared to intermittent bolus dosing, continuous propofol infusion provides lesser dose exposure without impacting recovery time or quality of the magnetic resonance imaging study.
间歇性推注异丙酚是小儿磁共振成像镇静的有效药物，但需要持续警惕和剂量滴定。磁共振成像兼容的输液泵可实现连续输注异丙酚，以较低的总剂量达到稳定的镇静水平。本研究调查了在接受脑和脊柱磁共振成像检查的儿童中，接受间歇性与连续输注异丙酚镇静的儿童的总异丙酚剂量、恢复时间和磁共振图像质量。
一项开放标签、前瞻性、随机、对照研究。一位单盲放射科医生对磁共振图像质量进行了评分。
儿童医院儿科放射科镇静中心。
170 名年龄在 1 个月至 18 岁的儿童，因脑、脊柱或脑和脊柱磁共振成像而接受深度镇静。
在获得知情同意后，患者被随机分配到两组：组 1（间歇性）接受 2-4mg/kg 的异丙酚推注，然后根据需要重复 0.5-2mg/kg/剂量的推注。组 C（连续）接受 2-4mg/kg 的异丙酚推注，然后以 100μg/kg/min 的速度持续输注，剂量为 1mg/kg，并根据滴注滴定效果给予推注。
测量了患者的人口统计学、镇静风险评估、异丙酚剂量、镇静恢复时间、并发症发生率和磁共振成像研究质量。共有 170 名儿童入组本研究，其中组 C 75 名，组 I 95 名。两组在年龄、体重、性别和磁共振成像研究类型方面均相似。与组 I （162±74μg/kg/min）相比，组 C 需要的异丙酚剂量较小（132±54μg/kg/min）（p=0.018）。两组之间在成像研究质量、恢复时间或并发症发生率方面没有差异。
与间歇性推注相比，连续输注异丙酚可减少剂量暴露，而不影响恢复时间或磁共振成像研究质量。
