{"id":27133,"date":"2025-01-10T04:31:00","date_gmt":"2025-01-09T20:31:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=27133"},"modified":"2025-01-10T05:52:00","modified_gmt":"2025-01-09T21:52:00","slug":"jama-netw-open%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e5%84%bf%e7%ab%a5%e6%8e%a5%e5%8f%97%e6%a0%b8%e7%a3%81%e5%85%b1%e6%8c%af%e6%a3%80%e6%9f%a5%e8%bf%87%e7%a8%8b%e4%b8%ad%e4%bd%bf%e7%94%a8","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=27133","title":{"rendered":"[JAMA Netw Open\u53d1\u8868\u8bba\u6587]\uff1a\u513f\u7ae5\u63a5\u53d7\u6838\u78c1\u5171\u632f\u68c0\u67e5\u8fc7\u7a0b\u4e2d\u4f7f\u7528\u4e19\u6cca\u915a\u6216\u4e19\u6cca\u915a\u8054\u5408\u6c2f\u80fa\u916e\u9547\u9759\u540e\u7684\u80ba\u4e0d\u5f20"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

Anesthesiology<\/p>\n\n\n\n

November 1, 2024<\/p>\n\n\n\n

Pulmonary Atelectasis After Sedation With Propofol vs Propofol-Ketamine for Magnetic Resonance Imaging in Children: A Randomized Clinical Trial<\/h1>\n\n\n\n

Yu Jeong Bang, Jeayoun Kim, Nam-Su Gil, et al<\/h3>\n\n\n\n

JAMA Netw Open. <\/em>2024;7(11):e2433029. doi:10.1001\/jamanetworkopen.2024.33029<\/h3>\n\n\n\n

<\/a>Key Points<\/p>\n\n\n\n

Question<\/strong>  What is the incidence of atelectasis among children sedated for magnetic resonance imaging with propofol vs propofol-ketamine?<\/p>\n\n\n\n

Findings<\/strong>  In this randomized clinical trial of 107 pediatric patients, the incidence of pulmonary atelectasis and the total lung score, which was evaluated by lung ultrasonography, were significantly lower in the propofol-ketamine sedation group compared with the propofol sedation group.<\/p>\n\n\n\n

Meaning<\/strong>  In pediatric patients undergoing magnetic resonance imaging under deep sedation, the propofol-ketamine combination reduced the frequency and severity of sedation-induced atelectasis while maintaining effective sedation and allowing a faster emergence time.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Little is known about the impact of different anesthetic agents used for routine magnetic resonance imaging (MRI) sedation on pulmonary function in children.<\/p>\n\n\n\n

Objective<\/strong>  To compare the incidence of pulmonary atelectasis after MRI sedation with propofol vs propofol-ketamine.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  This double-masked randomized clinical trial screened 117 consecutive pediatric patients aged 3 to 12 years with American Society of Anesthesiologists physical status I to II undergoing elective MRI under deep sedation from November 2, 2022, to April 28, 2023, at a tertiary referral center. Four patients met the exclusion criteria, and 5 patients refused to participate. The participants and outcome assessors were masked to the group allocation.<\/p>\n\n\n\n

Interventions<\/strong>  During the MRI, the propofol group received 0.2 mL\/kg of 1% propofol and 2 mL of 0.9% saline followed by a continuous infusion of propofol (200 \u03bcg\/kg\/min) and 0.9% saline (0.04 mL\/kg\/min). The propofol-ketamine group received 0.2 mL\/kg of 0.5% propofol and 1 mg\/kg of ketamine followed by a continuous infusion of propofol (100 \u03bcg\/kg\/min) and ketamine (20 \u03bcg\/kg\/min).<\/p>\n\n\n\n

Main Outcome and Measure<\/strong>  The incidence of atelectasis assessed by lung ultrasonography examination.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0A total of 107 children (median [IQR] age, 5 [4-6] years; 62 male [57.9%]), with 54 in the propofol group and 53 in the propofol-ketamine group, were analyzed in this study. Notably, 48 (88.9%) and 31 (58.5%) patients had atelectasis in the propofol and propofol-ketamine groups, respectively (relative risk, 0.7; 95% CI, 0.5-0.8;\u00a0P<\/em>\u2009<\u2009.001). The incidence of desaturation and interruption of the MRI due to airway intervention or spontaneous movement did not significantly differ between the groups. The propofol-ketamine group showed a faster emergence time than the propofol group (15 [9-23] vs 25 [22-27] minutes in the propofol-ketamine vs propofol group; median difference in time, 9.0 minutes; 95% CI, 6.0-12.0 minutes;\u00a0P<\/em>\u2009<\u2009.001). No patient was withdrawn from the trial due to adverse effects.<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  In this randomized clinical trial, the propofol-ketamine combination reduced sedation-induced atelectasis while allowing for faster emergence compared with propofol alone.<\/p>\n\n\n\n

Trial Registration<\/strong>  cris.nih.go.kr<\/a> Identifier: KCT0007699<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  Anesthesiology November&nb […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/27133"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=27133"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/27133\/revisions"}],"predecessor-version":[{"id":27529,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/27133\/revisions\/27529"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=27133"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=27133"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=27133"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}