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Safety and efficacy of propofol anesthesia for pediatric target-controlled infusion in children below 3 years of age: a retrospective observational study
背景与目的
虽然丙泊酚在儿童中的需求量逐渐增加，但对3岁以下儿童使用丙泊酚进行麻醉诱导和维持在韩国尚未获得批准。本研究可为增加其使用范围提供临床依据。
方 法
我们回顾了2013年9月至2016年12月期间接受手术的3岁以下患者的医疗记录。根据患者生命体征评估丙泊酚的安全性，并根据患者脑电双频指数（BIS）评估丙泊酚实验室结果和有效性。记录不良事件的发生情况。
结 果
在倾向评分匹配后对109例使用丙泊酚麻醉的患者（丙泊酚组）和109例使用吸入麻醉的患者（吸入麻醉组）进行比较。两组患者术中收缩压（P<0.001）和心率（P=0.03）下降的比例存在差异，但舒张压（P=0.238）和平均动脉压（P=0.175）差异无统计学意义。术后两组患者生命体征和出现不良事件的比例差异无统计学意义。
结 论
靶控输注丙泊酚用于麻醉是有效的，且围手术期未发生与丙泊酚相关的严重不良事件。
原始文献摘要
Kang P, Jang YE, Kim EH, Lee JH, Kim JT, Kim HS. Safety and efficacy of propofol anesthesia for pediatric target-controlled infusion in children below 3 years of age: a retrospective observational study.[J]. Expert Opin Drug Saf. 2018
Backgrand: Although the requirement of propofol in children is increasing, propofol for induction and maintenance of anesthesia below 3 years old has not been approved in Korea. This study can provide a clinical evidence to increase the range of approval.
Research design and methods: We reviewed the medical records of patients below 3 years of age who underwent surgery between September 2013 and December 2016. Safety was evaluated on the basis of vital signs, and laboratory findings and efficacy were evaluated on the basis of the bispectral index (BIS). Adverse events were examined.
Results：A total of 109 patients anesthetized with propofol (propofol group) were compared with 109 patients with volatile anesthetics (volatile group) after propensity score matching. There was a difference in the proportion of patients showing decreased systolic pressure (P <0.001) and heart rate (P = 0.03), but there was no difference in diastolic pressure (P = 0.238), mean arterial pressure (P= 0.175) during surgery. After surgery, there was no difference in all vital signs and the proportion patients who experienced adverse events of two groups.
Conclusion: Propofol anesthesia by target-controlled infusion was effective and didn't show seriouspropofol-related perioperative adverse events.
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