Division of Neonatology, Department of Pediatrics, Máxima Medical Center, Veldhoven, The Netherlands.
Division of Neonatology, Department of Pediatrics, Erasmus UMC - Sophia Children's Hospital, Rotterdam, The Netherlands.
Acta Paediatr. 2020 Dec;109(12):2539-2546. doi: 10.1111/apa.15282. Epub 2020 Apr 20.
To analyse the effects of different propofol starting doses as premedication for endotracheal intubation on blood pressure in neonates.
Neonates who received propofol starting doses of 1.0 mg/kg (n = 30), 1.5 mg/kg (n = 23) or 2.0 mg/kg (n = 26) as part of a previously published dose-finding study were included in this analysis. Blood pressure in the 3 dosing groups was analysed in the first 60 minutes after start of propofol.
Blood pressure declined after the start of propofol in all 3 dosing groups and was not restored 60 minutes after the start of propofol. The decline in blood pressure was highest in the 2.0 mg/kg dosing group. Blood pressure decline was mainly dependent on the initial propofol starting dose rather than the cumulative propofol dose.
Propofol causes a dose-dependent profound and prolonged decrease in blood pressure. The use of propofol should be carefully considered. When using propofol, starting with a low dose and titrating according to sedative effect seems the safest strategy.
分析不同异丙酚起始剂量作为气管内插管前用药对新生儿血压的影响。
本分析纳入了先前发表的一项剂量探索研究中接受 1.0mg/kg（n=30）、1.5mg/kg（n=23）或 2.0mg/kg（n=26）异丙酚起始剂量的新生儿。在开始使用异丙酚后的前 60 分钟分析 3 个剂量组的血压。
在所有 3 个剂量组中，在开始使用异丙酚后血压下降，在开始使用异丙酚后 60 分钟血压未恢复。在 2.0mg/kg 剂量组中血压下降幅度最大。血压下降主要取决于初始异丙酚起始剂量，而不是累积异丙酚剂量。
异丙酚引起剂量依赖性的严重和持久的血压下降。异丙酚的使用应谨慎考虑。当使用异丙酚时，起始使用低剂量并根据镇静效果滴定似乎是最安全的策略。
