前瞻性、随机比较两种静脉镇静方法在儿童磁共振成像中的应用。

Prospective, randomised comparison of two intravenous sedation methods for magnetic resonance imaging in children.

机构信息

Ośrodek Pediatryczny, Centralny Szpital Kliniczny Uniwersytetu Medycznego w Łodzi, Poland.

Departament of Neonatology, Medical University of Warsaw, Poland.

出版信息

Anaesthesiol Intensive Ther. 2023;55(2):81-86. doi: 10.5114/ait.2023.128715.

DOI:10.5114/ait.2023.128715

PMID:37409838

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10415600/

Abstract

BACKGROUND

Children usually need sedation or even anaesthesia for magnetic resonance imaging (MRI) studies. As there is no universally accepted method for this purpose we undertook a prospective, randomised comparison of propofol and dexmedetomidine in children aged 1 to 10 years.

METHODS

After Institutional Board approval and parents' informed consent 64 ASA status I or II children scheduled for MRI scan were enrolled. Patients were premedicated with intravenous (IV) midazolam (0.1 mg kg -1 ) and ketamine (1 mg kg -1 ) and randomised to propofol (P) or dexmedetomidine (D) group. A propofol bolus of 1 mg kg -1 followed by infusion of 4 mg kg -1 h -1 , or dexmedetomidine 1 µg kg -1 followed by 2 µg kg -1 h-1 infusion were used. Heart rate, SpO 2 and non-invasive blood pressure were monitored and recorded at 5 min intervals. Results were compared by means of standard statistical methods.

RESULTS

Both dexmedetomidine and propofol after premedication with ketamine and midazolam are suitable for MRI sedation, although propofol use results in shorter recovery time. Less interventions are needed when dexmedetomidine is used.

摘要

背景

儿童通常需要镇静甚至全身麻醉才能进行磁共振成像（MRI）检查。由于目前尚无普遍接受的方法，我们对 1 至 10 岁儿童进行了异丙酚和右美托咪定的前瞻性、随机比较。

方法

在机构委员会批准和家长知情同意后，纳入 64 名 ASA Ⅰ或Ⅱ级、计划进行 MRI 扫描的儿童。患者接受静脉（IV）咪达唑仑（0.1mg/kg）和氯胺酮（1mg/kg）预处理，然后随机分为异丙酚（P）或右美托咪定（D）组。异丙酚推注 1mg/kg，然后以 4mg/kg/h 的速度输注，或右美托咪定 1μg/kg，然后以 2μg/kg/h 的速度输注。每隔 5 分钟监测和记录心率、SpO2 和无创血压。结果采用标准统计方法进行比较。