临床小儿外科杂志2025，Vol.24Issue(5)：462-467,6.DOI:10.3760/cma.j.cn101785-202407023-012
脑电双频指数监测下丙泊酚靶控输注在肺炎支原体肺炎患儿支气管肺泡灌洗术中的应用
Application and safety analysis of target-controlled infusion of propofol in bronchoalveolar lavage for children with mycoplasma pneumoniae pneumonia under bispectral index monitoring
摘要
Abstract
Objective To evaluate the efficacy and safety of target-controlled infusion(TCI)of propofol under bispectral index(BIS)monitoring in children with mycoplasma pneumoniae pneumonia(MPP)undergo-ing bronchoalveolar lavage(BAL)with a flexible bronchoscopy.Methods A prospective study was conducted on 104 MPP children aged 3-8 years(ASA classification Ⅰ-Ⅱ)scheduled for BAL at Children's Hospital of Soochow University between March 2021 and March 2023.Patients were randomized into two groups(n=52):the TCI group,which received TCI of propofol starting at 2 μg·mL-1,and the constant-rate infusion(CI)group,which received propofol at 3-5 mg·kg-1·h-1.Both groups underwent anesthesia with midazolam(0.05 mg·kg-1),fentanyl(2 μg·kg-1),and cisatracurium(0.12 mg·kg-1)under BIS monitoring.Intra-operative parameters,including mean arterial pressure(MAP),heart rate(HR),and oxygen saturation(SpO2),were recorded at pre-induction(T0),bronchoscope arrival at carina(T1),start of lavage(T2),end of lavage(T3),and 30 minutes post-drug discontinuation(T4).Agitation and Ramsay sedation scores were as-sessed during bronchoscope insertion and at 10,20,and 30 minutes after bronchoscope removal.Pre-and postop-erative plasma cortisol and blood glucose levels were measured,and adverse events were recorded.Result-s There were no significant differences in MAP,HR,or SpO2 at T0 between the two groups(P＞0.05).MAP was lower in the TCI group at T1,T3,and T4 compared to the CI group(P＜0.05),but no significant differ-ences were observed at T2,nor in HR and SpO2 across all time points(P＞0.05).No significant differences were found in the time from anesthesia induction to bronchoscope insertion,surgical duration,or time to full re-covery of consciousness(P＞0.05).The average number of bronchoscope reinsertions was lower in the TCI group(P＜0.05).Agitation and Ramsay scores during bronchoscope insertion showed no significant differences(P＞0.05),but agitation scores were significantly lower and Ramsay sedation scores higher at bronchoscope re-moval and at 10,20,and 30 minutes afterward in the TCI group(P＜0.05).Postoperative plasma cortisol and blood glucose levels increased in both groups(P＜0.05),but were significantly lower in the TCI group com-pared to the CI group(P＜0.05).The incidence of adverse events did not differ significantly between groups(P＞0.05).Conclusions Target-controlled infusion of propofol under BIS monitoring provides effective anes-thesia with minimal hemodynamic and stress responses in children with MPP undergoing BAL.关键词
肺炎,支原体/支气管肺泡灌洗/二异丙酚/儿童Key words
Mycoplasma Pneumoniae/Bronchoalvelar Lavage/Propofol/Surgical Procedures,Opera-tive/Child引用本文复制引用
仲梦杰,谢颖祥,陈霞,王谦..脑电双频指数监测下丙泊酚靶控输注在肺炎支原体肺炎患儿支气管肺泡灌洗术中的应用[J].临床小儿外科杂志,2025,24(5):462-467,6.基金项目
苏州市科技计划(医疗卫生科技创新)项目(SKY2022055) Suzhou Municipal Science and Technology(Medical and Health Technology Innovation)Project(SKY2022055) （医疗卫生科技创新）
