The Clinical Studies On Sedative Effects Of Intraspinal Anesthesia Assisted With Target Controlled Infusion Of Propofol In Different Ages Pediatric Patients

Objective:To study the more reasonable effect cabinet concentration to assist intraspinal anesthesia with target controlled infusion of propofol in different ages of pediatric patients,and to evaluate the sedative effect.Methods:Seventy three pediatric patients classified as ASA physical statusâ… undergoing lower abdomen operation were divided into three groups(0～3 yr,4～8 yr,9～12 yr)in accordance with age.Iner each group was re-divided into three groups by different effect cabinet concentration(2.5μg/ml,3.0μg/ml,3.5μg/ml).All children were injected intramuscularly with atropine 0.01～0.02mg/kg and ketamine 6～8mg/kg before entering operation room.After sacral anesthesia or epidural anaesthesia,electroencephalogram,electrocardiogram,blood pressure,SpO₂ were continuously monitored.The following indices were recorded and compared among the three concentration groups of each age group:changes of HR,MAP,RR,SpO₂,BIS in pre-anesthesia,skin incision,after propofol induction 1 minute,3 minutes,5 minutes and stop propofol infusion,after that 5 minutes,10minutes,the incidence of adverse effects:body movement during operation,respiretory depression, hypotension,restlessness after operation,nausea and vomiting post operation and awareness.The prediction recovery time by TCI computor and the actual recovery time.Results:There was nonawareness in all ages children by effect cabinet concentration of propofol.Circulatory and respiratory system were stable in 0～3 yr chilidren by 2.5μg/ml.And respiratory depression significantly increased by 3.0μg/ml and 3.5μg/mg. Circulatory and respiratory system were stable in 4～8 yr chilidren by 3.0μg/ml and 3.5μg/mg.And body movement increased by 2.5μg/ml. Circulatory and respiratory system were stable in 9～12 yr chilidren by 3.0μg/ml and 3.5μg/ml.And bodyment significantly increased by 2.5μg/ml.The actual recovery time significantly longer than TCI computor prediction recovery time in younger children,and the actual recovery time approach to TCI prediction time in older age group.There were no restlessness and postoperation nausea and vomiting in all children.Conclusion:Target controlled infusion of propofol as an adjuvant for intraspinal anesthesia is applicable and can be effective sedation degree by 2.5μg/ml,3.0μg/ml and 3.5μg/ml as effect cabinet concentration.Compared the sedative effects and adverse effects, 2.5μg/ml is better than 3.0μg/ml and 3.5μg/ml in 0～3 yr children,3.0μg/ml and 3.5μg/ml are better than 2.5μg/ml in 4～12 yr children.