Blanco D, Montes A, Moreno V, Costa J, Alloza P, Vidal F
Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario de Badalona Germans Trias i Pujol, Barcelona.
Rev Esp Anestesiol Reanim. 1994 May-Jun;41(3):152-5.
To study ED50 and ED90 induction doses of propofol in children.
Seventy-two children from 1 to 110 months of age and premedicated with pentobarbital 4 mg/kg participated in the study. Seven different doses of propofol (1.5, 2, 2.5, 3, 3.5, 4 and 4.5 mg/kg) were injected into the dorsal hand or foot vein in 30 seconds. We measured the response to application of the mask, corneal reflex and response to trapezius muscle compression 30 and 60 s after administration. A log-probit statistical analysis was used and complications were noted.
The doses that produced 50% elimination of reflexes (ED50) or 90% elimination (ED90) in our patients were 1.74 and 3.95 mg/kg for response to mask; 2.47 and 4.26 mg/kg for elimination of corneal reflex; and 3.27 and 4.79 mg/kg for compression of trapezius. Frequency of pain upon injection was 74% and that of spontaneous movement was 12%. Apnea (breathing halted for longer than 20 s) occurred in 7% of our patients. We recorded no cases of broncho or laryngeal spasm, or skin rash.
Induction with propofol is appropriate given the rarity of stimulant effects, but there is a high frequency of pain upon injection, limiting the usefulness of this drug for anesthetic induction in pediatrics. ED50 and ED90 varies depending on the stimulus assessed.
研究丙泊酚用于儿童的半数有效诱导剂量(ED50)和90%有效诱导剂量(ED90)。
72名年龄在1至110个月的儿童参与了本研究,这些儿童术前使用了4mg/kg的戊巴比妥进行预处理。将七种不同剂量的丙泊酚(1.5、2、2.5、3、3.5、4和4.5mg/kg)在30秒内注入手背或足背静脉。在给药后30秒和60秒,我们测量了患儿对面罩应用的反应、角膜反射以及对斜方肌压迫的反应。采用对数概率统计分析并记录并发症情况。
在我们的患者中,导致50%反射消失(ED50)或90%反射消失(ED90)的剂量,对于面罩反应分别为1.74mg/kg和3.95mg/kg;对于角膜反射消失分别为2.47mg/kg和4.26mg/kg;对于斜方肌压迫分别为3.27mg/kg和4.79mg/kg。注射时疼痛的发生率为74%,自发运动的发生率为12%。7%的患者出现呼吸暂停(呼吸停止超过20秒)。我们未记录到支气管或喉痉挛或皮疹的病例。
鉴于刺激性反应罕见,丙泊酚诱导是合适的,但注射时疼痛发生率高,限制了该药物在儿科麻醉诱导中的应用。ED50和ED90因所评估的刺激不同而有所变化。