Pediyatrik hastalarda propofol ile yapılan intravenöz anestezi ile inhalasyon anestezisinin karşılaştırılması

Abstract

SUMMARY In our study, it was intended to compare propofol intravenous anaesthesia with halothane inhalation anaesthesia which we used in the management of pediatric patients during magnetic resonance imaging (MRI) scans for obtaining motionless to get good quality images. A total of randomly selected 40 patients between 1 to 108 months of age were studied in two groups each consisting of 20 patients, which are namely halothane and propofol. In the halothane group, an intravenous catheter was placed after the anaesthesia was induced with halothane which we continiously infused untill the globes centralized and the pupils became miotic and stopped at the start of MRI scan. In the propofol group, similarly the intravenous catheter was placed after the anaesthesia was induced with halotan and stopped to give an intravenous bolus of 0.5 mg/kg of propofol which was continiously being infused at a dose of 10 mg/kg/hour and stopped 2 minutes before the end of MRI scan. No oxygen was given to any of the patients during the scan; all breathed spontaneously in the room air. In both groups, the induction, scan, total anaesthesia and recovery times, the heart and the ventilatory rates, oxygen saturation, end tidal C02 at the 5th, 10th, 15th minutes and the end of the scan, the time of the patient's first motion, if any, were recorded. We found that the induction time was significantly shorter in propofol group (p<0.05). Also in the same group, significantly fewer patients moved during the scan (p<0.05). In both groups, the heart rate showed a significant decrease during the scan (p<0.05). 50Ventilatory rate values at the 10th, 15th minutes and the end of the scan in the halothane groups and all values in the propofol group were significantly lower than their initial values (p<0.05); however oxygen saturation did not drop under the level of % 94.85 +. 1.84 at any record time. End tidal COz values at 10th and 15th minutes in the halothane group were significantly high and at all record times in the propofol group (p<0.05). We did not observe an ETC02 value under the level of % 48 ± 3.49 mmHg at any record time. There were no significant difference between the heart and the ventilatory rate values of the two groups (p>0.05). 02 saturation values at the 10th, 15th minutes and the end of the scan in the propofol group were significantly lower than the halothane group (p<0.05). Although the ETC02 value athe time of the patient's awake in the propofol group was found to be significantly higher than the halotan group (p<0.05), that has no clinical significance. No adverse reactions to the drugs were observed in any of the groups. In conclusion, we belive that intravenous anaesthesia with propofol infusion is a satisfactory method for children undergoing MRI scans. 51

SUMMARY In our study, it was intended to compare propofol intravenous anaesthesia with halothane inhalation anaesthesia which we used in the management of pediatric patients during magnetic resonance imaging (MRI) scans for obtaining motionless to get good quality images. A total of randomly selected 40 patients between 1 to 108 months of age were studied in two groups each consisting of 20 patients, which are namely halothane and propofol. In the halothane group, an intravenous catheter was placed after the anaesthesia was induced with halothane which we continiously infused untill the globes centralized and the pupils became miotic and stopped at the start of MRI scan. In the propofol group, similarly the intravenous catheter was placed after the anaesthesia was induced with halotan and stopped to give an intravenous bolus of 0.5 mg/kg of propofol which was continiously being infused at a dose of 10 mg/kg/hour and stopped 2 minutes before the end of MRI scan. No oxygen was given to any of the patients during the scan; all breathed spontaneously in the room air. In both groups, the induction, scan, total anaesthesia and recovery times, the heart and the ventilatory rates, oxygen saturation, end tidal C02 at the 5th, 10th, 15th minutes and the end of the scan, the time of the patient's first motion, if any, were recorded. We found that the induction time was significantly shorter in propofol group (p<0.05). Also in the same group, significantly fewer patients moved during the scan (p<0.05). In both groups, the heart rate showed a significant decrease during the scan (p<0.05). 50Ventilatory rate values at the 10*, 15* minutes and the end of the scan in the halothane groups and ali values in the propofol group were significantiy lower than their initial values (p<0.05); however oxygen saturation did not drop under the level of % 94.85 +. 1.84 at any record time. End tidal CO2 values at 10* and 15* minutes in the halothane group were significantiy high and at ali record times in the propofol group (p<0.05). We did not observe an ETCO2 value under the level of % 48 +. 3.49 mmHg at any record time. There were no significant difference between the heart and the ventilatory rate values of the two groups (p > 0.05). O2 saturation values at the 10*, 15* minutes and the end of the scan in the propofol group were significantiy lower than the halothane group (p<0.05). Although the ETCO2 value athe time of the patient's awake in the propofol group was found to be significantiy higher than the halotan group (p<0.05), that has no clinical significance. No adverse reactions to the drugs were observed in any of the groups. in conclusion, we belive that intravenous anaesthesia with propofol infusion is a satisfactory method for children undergoing MRI seans.