Scheiber G, Ribeiro F C, Karpienski H, Strehl K
Department of Anaesthesiology, University Hospital, Essen, Germany.
Paediatr Anaesth. 1996;6(3):209-13. doi: 10.1111/j.1460-9592.1996.tb00430.x.
Immobilization of children undergoing radiation therapy always requires anaesthesia. Deep sedation with continuous infusion of propofol and spontaneous breathing, (we call it ¿sedative anaesthesia'), may be an alternative to general anaesthesia with intubation and controlled ventilation. This clinical report deals with 155 anaesthetics performed in 11 consecutive paediatric oncology patients, mean age 30 months (range 19-42), who required radiation therapy for from seven to 33 consecutive days. Mean duration of anaesthesia was 18 ( +/- 11) mins. For induction, a loading dose of 3.6 (SD +/- 0.59) mg.kg-1 propofol was administered immediately followed by a continuous infusion of 7.4 ( +/- 2.2) mg.kg-1.h-1 for maintenance of anaesthesia. There were no complications of clinical importance involving respiration, circulation or neurology, except for one short episode of transient desaturation, which was managed by suctioning and changing head position. Children opened their eyes spontaneously four ( +/- 3.7) min after discontinuing the propofol infusion and could be discharged about 30 mins later. Tachyphylaxis or unpleasant side effects during and after anesthesia have not been observed. Sedative anaesthesia with propofol seems to be an excellent method to immobilize paediatric patients during radiotherapeutic procedures.
接受放射治疗的儿童进行固定时总是需要麻醉。持续输注丙泊酚并自主呼吸的深度镇静(我们称之为“镇静麻醉”)可能是插管全身麻醉和控制通气的替代方法。本临床报告涉及对11例连续的儿科肿瘤患者进行的155次麻醉,这些患者平均年龄30个月(范围19 - 42个月),需要连续7至33天接受放射治疗。平均麻醉持续时间为18(±11)分钟。诱导时,立即给予负荷剂量3.6(标准差±0.59)mg·kg⁻¹的丙泊酚,随后持续输注7.4(±2.2)mg·kg⁻¹·h⁻¹以维持麻醉。除了一次短暂的短暂性血氧饱和度降低发作,通过吸引和改变头部位置处理外,没有涉及呼吸、循环或神经学的具有临床重要性的并发症。停止丙泊酚输注后,儿童在4(±3.7)分钟后自主睁眼,约30分钟后可出院。未观察到麻醉期间及之后的快速耐受或不良副作用。丙泊酚镇静麻醉似乎是在放射治疗过程中固定儿科患者的一种极好方法。