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小儿门诊患者的丙泊酚麻醉:与硫喷妥钠和氟烷的比较。

Propofol anaesthesia in paediatric ambulatory patients: a comparison with thiopentone and halothane.

作者信息

Hannallah R S, Britton J T, Schafer P G, Patel R I, Norden J M

机构信息

Department of Anesthesiology, Children's National Medical Center, Washington, D.C. 20010.

出版信息

Can J Anaesth. 1994 Jan;41(1):12-8. doi: 10.1007/BF03009654.

Abstract

The purpose of this study was to evaluate the haemodynamic changes during induction, as well as the speed and quality of recovery when propofol (vs thiopentone and/or halothane) was used for induction and maintenance of anaesthesia in paediatric outpatients. One hundred unmedicated children, 3-12-yr-old, scheduled for ambulatory surgery were studied. The most common surgical procedures performed were eye muscle surgery (42%), plastic surgery (21%), dental restoration (15%), and urological procedures (15%). The children were randomized to an anaesthetic regimen for induction/maintenance as follows: propofol/propofol infusion; propofol/halothane; thiopentone/halothane; halothane for both induction and maintenance. Succinylcholine 1.5 mg.kg-1 was used to facilitate tracheal intubation and N2O/O2 were used as the carrier gases in each case. All maintenance drugs were titrated according to the clinical response of the patient to prevent movement and/or maintain BP +/- 20% of baseline. Two patients (4%) who received propofol expressed discomfort during injection. The mean propofol dose required to prevent movement was 267 +/- 83 micrograms.kg-1.min-1. The overall pattern of haemodynamic changes, as well as awakening (extubation) times were not different among the four groups. Children who received propofol recovered faster (22 vs 29-36 min) (P < 0.05), were discharged home sooner (101 vs 127-144 min) (P < 0.05), and had less postoperative vomiting (4 vs 24-48%) (P < 0.05) than all others.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本研究旨在评估小儿门诊患者麻醉诱导期间的血流动力学变化,以及使用丙泊酚(对比硫喷妥钠和/或氟烷)进行麻醉诱导和维持时的恢复速度及质量。研究了100例3至12岁未用药、计划进行门诊手术的儿童。最常见的手术操作包括眼部肌肉手术(42%)、整形手术(21%)、牙齿修复(15%)和泌尿外科手术(15%)。将儿童随机分为以下诱导/维持麻醉方案组:丙泊酚/丙泊酚输注;丙泊酚/氟烷;硫喷妥钠/氟烷;诱导和维持均用氟烷。使用1.5mg.kg-1琥珀酰胆碱辅助气管插管,每种情况均使用N2O/O2作为载气。所有维持药物均根据患者的临床反应进行滴定,以防止移动和/或维持血压在基线值的±20%以内。两名接受丙泊酚的患者(4%)在注射期间表示不适。防止移动所需的丙泊酚平均剂量为267±83微克.kg-1.min-1。四组之间血流动力学变化的总体模式以及苏醒(拔管)时间并无差异。接受丙泊酚的儿童恢复更快(22分钟对比29至36分钟)(P<0.05),更早出院回家(101分钟对比127至144分钟)(P<0.05),且术后呕吐较少(4%对比24至48%)(P<0.05)。(摘要截取自250字)

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