儿科重症监护中的镇静和神经肌肉阻滞：英国当前实践综述
Sedation and neuromuscular blockade in paediatric intensive care: a review of current practice in the UK.
作者信息
Playfor Stephen D, Thomas David A, Choonara Imti
机构信息
Paediatric Intensive Care Unit, Royal Manchester Children's Hospital, Hospital Road, Pendlebury, Manchester M27 4HA, UK.
出版信息
Paediatr Anaesth. 2003 Feb;13(2):147-51. doi: 10.1046/j.1460-9592.2003.00989.x.
BACKGROUND
Our aim was to investigate the current practice of sedation and neuromuscular blockade in critically ill children in paediatric intensive care units (PICUs) in the UK.
METHODS
A postal questionnaire was sent to all PICUs in the UK.
RESULTS
The most commonly used sedative agents were midazolam in combination with morphine. Written clinical guidelines for the sedation of critically ill children were available in 45% of units. Sedation is formally assessed in 40% of units. Vecuronium is the most commonly used neuromuscular blocking agent. In the UK, 31% of critically ill children are likely to receive neuromuscular blocking agents. Depth of neuromuscular blockade is routinely assessed in 16% of patients.
CONCLUSIONS
Relatively few units possess clinical guidelines for the sedation of critically ill children, and only a minority formally assess sedation levels. Where neuromuscular blocking agents are administered, sedation is frequently inadequately assessed and the depth of neuromuscular blockade is rarely estimated.
背景
我们的目的是调查英国儿科重症监护病房（PICUs）中危重症儿童镇静和神经肌肉阻滞的当前应用情况。
方法
向英国所有的PICUs发送了一份邮政调查问卷。
结果
最常用的镇静剂是咪达唑仑联合吗啡。45%的单位有关于危重症儿童镇静的书面临床指南。40%的单位会对镇静进行正式评估。维库溴铵是最常用的神经肌肉阻滞剂。在英国，31%的危重症儿童可能会接受神经肌肉阻滞剂。仅16%的患者会常规评估神经肌肉阻滞的深度。
结论
相对较少的单位拥有关于危重症儿童镇静的临床指南，只有少数单位会正式评估镇静水平。在使用神经肌肉阻滞剂的情况下，镇静评估常常不充分，且很少评估神经肌肉阻滞的深度。
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