Clinical study of propofol sedation with paedfusor model via target control infusion in dressing operation for 1-3 years old children with burn
Fei Xiang
Sun Xuefeng
Li Mengmeng
Hao Jianhua
Mi Weidong
Abstract：Objective:To study the efficacy and safety of propofol sedation via target control infusion (TCI) with paedfusor model during burn dressing change for children of 1-3 years old and to evaluate the use of Narco-trend as a tool for measuring the depth of sedation. Methods:Thirty children scheduled for elective burn dressing change (admitted form January 2013 to June 2013,age 1 to 3 years old,ASA grades I-Ⅱ,burn area<30%TB-SA,burn depthⅡ-Ⅲ degree)were involved in the study. The TCI device was programmed with paedfusor pharmcokinetic model,and Alaris PK TCI pump. The depth of sedation was assayed by Ramsay score. The target plasma concentration of propofol was started at 5μg/ml,till an adequate sedation (Ramsay≥5 )was secured be-fore the dressing change,and 2 μg/ml propofol was inj ected intravenously.Before the operation,target was re-duced to 4μg/ml and adj usted with 0.5 μg/ml if patients had limbs movement,and the upper limit was 6 μg/ml.The blood pressure,heart rate,the Narcotrend,Ramsay,predicted blood propofol concentration(Cp )were monitored at induction period,during operation and after operation. The time of induction,time of makening and complications were observed. The relationship among Cp,Ramsay,and Narcotrend was analyzed. Results:Five minutes after TCI,blood pressure and heart rate lowered and then maintained at stable level.One child showed ap-nea (SpO2<0.90),and 2 children showed agitation.The mean induction time was (3.1 ±0.6)minutes,and the minimum Narcotrend index was 4 2.5 ± 6.1;mean recovery time (Ramsay grade from≥5 to ≤2 )was (1 2.5 ±3.2)minutes,and at the same time,Cp was (1.9±0.2)μg/ml and Narcotrend index was 88.2±4.3. Cp was posi-tively correlated with Ramsay (r=0.968,P<0.001)and negatively correlated with Narcotrend (r=-0.898,P<0.001),while Ramsay was negatively correlated with Narcotrend(r=-0.948,P<0.001).Conclusions:Propofol sedation via TCI programmed with paedfusor pharmacokinetic parameters is safe and effective during pediatric burn dressing change. The Narcotrend index is well correlated with the sedation score,and it may be one of the reliable index to guide the depth of sedation for 1-3-year old children with paedfusor pharmacokinetic TCI mode.
Keywords：Burn dressing changeAnaesthesiologyTarget control infusionPropofolPaedfusor model
Publication Date：2014-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 45-48 )