Department of Paediatrics, Catholic University Medical School, Rome, Italy.
Acta Paediatr. 2014 Feb;103(2):182-7. doi: 10.1111/apa.12472. Epub 2013 Dec 3.
The aim of this study was to determine the safety and the efficacy of paediatrician-administered propofol in children undergoing different painful procedures.
We conducted a retrospective study over a 12-year period in three Italian hospitals. A specific training protocol was developed in each institution to train paediatricians administering propofol for painful procedures.
In this study, 36,516 procedural sedations were performed. Deep sedation was achieved in all patients. None of the children experienced severe side effects or prolonged hospitalisation. There were six calls to the emergency team (0.02%): three for prolonged laryngospasm, one for bleeding, one for intestinal perforation and one during lumbar puncture. Nineteen patients (0.05%) developed hypotension requiring saline solution administration, 128 children (0.4%) needed O2 ventilation by face mask, mainly during upper endoscopy, 78 (0.2%) patients experienced laryngospasm, and 15 (0.04%) had bronchospasm. There were no differences in the incidence of major complications among the three hospitals, while minor complications were higher in children undergoing gastroscopy.
This multicentre study demonstrates the safety and the efficacy of paediatrician-administered propofol for procedural sedation in children and highlights the importance of appropriate training for paediatricians to increase the safety of this procedure in children.
本研究旨在确定儿科医生在为接受不同疼痛程序的儿童管理异丙酚的安全性和疗效。
我们在意大利的三家医院进行了为期 12 年的回顾性研究。在每家机构都制定了专门的培训方案，以培训管理异丙酚用于疼痛程序的儿科医生。
在这项研究中，共进行了 36516 次程序性镇静。所有患者均达到深度镇静。没有患儿出现严重的副作用或延长住院时间。有 6 次呼叫急救团队（0.02%）：3 次为长时间的喉痉挛，1 次为出血，1 次为肠穿孔，1 次为腰椎穿刺。19 名患者（0.05%）出现低血压，需要给予生理盐水，128 名儿童（0.4%）需要通过面罩吸氧，主要是在进行上内窥镜检查时，78 名患者（0.2%）出现喉痉挛，15 名（0.04%）出现支气管痉挛。在这三家医院中，主要并发症的发生率没有差异，而在接受胃镜检查的儿童中，轻微并发症较高。
这项多中心研究表明，儿科医生管理异丙酚用于儿童程序性镇静是安全有效的，并强调了为儿科医生提供适当培训以提高该程序在儿童中的安全性的重要性。
