The combination of dexmedetomidine and propofol for sedation in pediatric patients undergoing regional anesthesia / 中国基层医药

ABSTRACT

Objective To evaluate the effectiveness and safety of the combination of dexmedetomidine and propofol for sedation in pediatrics undergoing regional anesthesia.Methods Forty-eight children aged 2 -6 years old,scheduled for elective surgery under regional anesthesia,were randomly divided into the two groups.The dexme-detomidine plus propofol group(group DP,n=24)received an infusion over 10 minutes of dexmedetomidine 0.7μg/kg and propofol 1.0 to 2.5 mg/kg bolus for induction,then an infusion of dexmedetomidine 0.5μg·kg-1·h-1 and propofol 100-300μg·kg-1·min-1 for maintenance.The propofol group(group P,n=24)received a propofol 1.0 to 2.5mg/kg bolus for induction,then an infusion of propofol 150 -300μg·kg-1 ·min-1 for maintenance.If body movement was detected during surgery,a bolus of propofol 1 .0mg/kg was administered in both groups,and if there was another body movement within three minutes of the propofol bolus,a bolus of ketamine 1 .0mg/kg was adminis-tered.Hemodynamic data,respiratory rate,and oxygen saturation were recorded by researchers blinded to the study drugs.Recovery time and the primary outcome were evaluated by a modified Aldrete score.The occurrence of adverse events and the amount of supplemental ketamine used were also recorded.Results The consumption of propofol in the group DP was (149.00 ±24.93)μg·kg-1·min-1,and in the group P was (217.00 ±17.90)μg·kg-1· min-1.The propofol consumption was significant lower that in group DP(t=117.94,P=0.00).The needs for sup-plemental ketamine bolus in the group DP was 0.50(1.00)/case,and it was 2.00(1.00)/case in group P.The need for supplemental ketamine was less in group DP(Z=-4.48,P=0.00).Hypopnea occurred in 5 cases in group P, and 0 in group DP.The incidence of hypopnea was more in group P(χ2 =5.58,P=0.03).In group DP,the mean arterial pressure and heart rate at discharge were respectively (74.96 ±5.69)mmHg and (101.17 ±9.65)bpm,and their baseline values were (81.13 ±7.23)mmHg and (112.00 ±13.65)bpm.Both mean arterial pressure and heart rate in the group DP remained decreased at discharge(t=10.78,P=0.00;t=10.08,P=0.00;respectively).The discharge time of the group DP was (40.91 ±10.90)min and it was(39.67 ±14.95)min in group P.There was no significant difference in the discharge time(t=0.11,P=0.74).Conclusion The combination of dexmedetomidine and propofol can provide appropriate depth of sedation in pediatric patients undergoing regional anesthesia.