Clinic of Anaesthesiology, SRH Wald-Klinikum Gera GmbH, Straße des Friedens 122, 07548 Gera, Germany.
Br J Anaesth. 2013 Jun;110(6):1001-9. doi: 10.1093/bja/aet002. Epub 2013 Feb 10.
Propofol is increasingly used in paediatric anaesthesia, but can be challenging to titrate accurately in this group. Mid-latency auditory-evoked potentials (MLAEPs) can be used to help titrate propofol. However, the effects of propofol on MLAEP in children are unclear. Therefore, we investigated the relationship between propofol and MLAEP in children undergoing anaesthesia.
Fourteen healthy children aged 4-16 yr received anaesthesia for elective surgery. Before surgery, propofol was administered in three concentrations (3, 6, 9 µg ml(-1)) through a target-controlled infusion pump using Kataria and colleagues' model. MLAEPs were recorded 5 min after having reached each target propofol concentration at each respective concentration. Additionally, venous propofol blood concentrations were assayed at each measuring time point.
Propofol increased all four MLAEP peak latencies (peaks Na, Pa, Nb, P1) in a dose-dependent manner. In addition, the differences in amplitudes were significantly smaller with increasing propofol target concentrations. The measured propofol plasma concentrations correlated positively with the latencies of the peaks Na, Pa, and Nb.
Propofol affects MLAEP latencies and amplitudes in children in a dose-dependent manner. MLAEP measurement might therefore be a useful tool for monitoring depth of propofol anaesthesia in children.
异丙酚在小儿麻醉中越来越多地被使用，但在该群体中准确滴定可能具有挑战性。中潜伏期听觉诱发电位（MLAEP）可用于帮助滴定异丙酚。然而，异丙酚对儿童 MLAEP 的影响尚不清楚。因此，我们研究了麻醉中儿童异丙酚与 MLAEP 的关系。
14 名 4-16 岁的健康儿童接受择期手术麻醉。手术前，通过靶控输注泵使用 Kataria 及其同事的模型以三种浓度（3、6、9 µg ml(-1)）给予异丙酚。在达到每个目标异丙酚浓度后 5 分钟，在每个相应浓度下记录 MLAEPs。此外，在每个测量时间点检测静脉内异丙酚血药浓度。
异丙酚以剂量依赖性方式增加了所有四个 MLAEP 峰潜伏期（峰 Na、Pa、Nb、P1）。此外，随着异丙酚目标浓度的增加，幅度差异明显变小。测量的异丙酚血浆浓度与峰 Na、Pa 和 Nb 的潜伏期呈正相关。
异丙酚以剂量依赖性方式影响儿童的 MLAEP 潜伏期和幅度。因此，MLAEP 测量可能是监测儿童异丙酚麻醉深度的有用工具。
