PROPOFOL ANESTHESIA IN PEDIATRIC AMBULATORY PATIENTS - A COMPARISON WITH THIOPENTONE AND HALOTHANE
PROPOFOL ANESTHESIA IN PEDIATRIC AMBULATORY PATIENTS - A COMPARISON WITH THIOPENTONE AND HALOTHANE
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DOI：
10.1007/bf03009654
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发表时间：
1994-01-01
期刊：
影响因子：
--
通讯作者：
NORDEN, JM
中科院分区：
文献类型：
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作者：
HANNALLAH, RS;BRITTON, JT;NORDEN, JM
本研究的目的是评估诱导期间的血流动力学变化，以及异丙酚（与硫喷妥钠和/或氟烷）用于儿科门诊患者麻醉诱导和维持时的恢复速度和质量。研究了100名3-12岁的未用药儿童，计划进行门诊手术。最常见的外科手术是眼肌手术（42%）、整形手术（21%）、牙科修复（15%）和泌尿外科手术（15%）。将儿童随机分配至以下麻醉方案进行诱导/维持：丙泊酚/丙泊酚输注;丙泊酚/氟烷;硫喷妥钠/氟烷;氟烷用于诱导和维持。琥珀酰胆碱1.5 mg.kg（-l）用于辅助气管插管，并且在每种情况下使用N2 O/O-2作为载气。根据患者的临床反应滴定所有维持药物，以防止运动和/或维持BP +/- 20%的基线。两名接受丙泊酚的患者（4%）在注射过程中表示不适。防止运动所需的平均丙泊酚剂量为267 ± 83 μ g.kg（-1）.min（-1）。血流动力学变化的总体模式以及苏醒（拔管）时间在四组之间没有差异。异丙酚组患儿恢复快（22 vs 29-36 min）（P < 0.05），出院早（101 vs 127-144 min）（P < 0.05），术后呕吐少（4 vs 24-48%）（P < 0.05）。研究中的任何患者均未出现严重并发症或不良术后后遗症。结论是，丙泊酚诱导和维持麻醉在儿童中是一种耐受性良好的麻醉技术，与使用氟烷相比，恢复和出院更快，呕吐更少。
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(-l) was used to facilitate tracheal intubation and N2O/O-2 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 mu g.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. There were no serious complications or adverse postoperative sequelae in any of the patients in the study It is concluded that induction and maintenance of anaesthesia with propofol is a well-tolerated anaesthetic technique in children, and is associated with faster recovery and discharged as well as less vomiting than when halothane is used.