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褪黑素对接受磁共振成像检查的儿童镇静作用的影响。

The effect of melatonin on sedation of children undergoing magnetic resonance imaging.

作者信息

Sury M R J, Fairweather K

机构信息

Department of Anaesthesia, Great Ormond Street Hospital for Children NHS Trust, London, UK.

出版信息

Br J Anaesth. 2006 Aug;97(2):220-5. doi: 10.1093/bja/ael144. Epub 2006 Jun 17.

Abstract

BACKGROUND

Melatonin may induce a natural sleepiness and improve predictability of sedation drugs. We have investigated its clinical value in children sedated for magnetic resonance imaging.

METHODS

In a stratified randomized double-blind study, 98 children received either melatonin or placebo 10 min before they were sedated with a standard oral regimen. Children >5 and <15 kg received chloral hydrate and those >or=15 and <40 kg had a combination of temazepam with droperidol (T&D). The doses of melatonin were 3 and 6 mg, respectively. One observer recorded the time taken to reach criteria for deep sedation, sedation failure and other sedation-related events.

RESULTS

In the chloral hydrate group (n=50) 50% were deeply sedated by 31 min after melatonin and 40 min after placebo (P=0.57). There were zero and 1 failures, respectively. The geometric mean time taken to reach deep sedation was 39 min in both subgroups. In the T&D group (n=48) 50% were deeply sedated by 70 min in both subgroups (two failures in each); geometric mean times were 68 and 71 min, respectively (P=0.58). Children closed their eyes slightly earlier after melatonin (respective geometric means 42 vs 48, P=0.17), and took slightly longer to achieve discharge criteria (146 vs 135, P=0.47).

CONCLUSION

In these doses and clinical conditions, melatonin did not contribute to sedation of children.

摘要

背景

褪黑素可能会诱发自然的困倦感,并提高镇静药物的可预测性。我们研究了其在接受磁共振成像镇静的儿童中的临床价值。

方法

在一项分层随机双盲研究中,98名儿童在采用标准口服方案进行镇静前10分钟接受褪黑素或安慰剂治疗。体重>5且<15 kg的儿童接受水合氯醛,体重>或=15且<40 kg的儿童接受替马西泮与氟哌利多(T&D)的联合用药。褪黑素的剂量分别为3毫克和6毫克。一名观察者记录达到深度镇静标准、镇静失败及其他与镇静相关事件所需的时间。

结果

在水合氯醛组(n = 50)中,褪黑素组在31分钟后有50%达到深度镇静,安慰剂组在40分钟后达到(P = 0.57)。两组分别有0例和1例镇静失败。两个亚组达到深度镇静的几何平均时间均为39分钟。在T&D组(n = 48)中,两个亚组均在70分钟时有50%达到深度镇静(每组有2例失败);几何平均时间分别为68分钟和71分钟(P = 0.58)。服用褪黑素后儿童闭眼稍早(几何平均数分别为42对48,P = 0.17),达到出院标准所需时间稍长(146对135,P = 0.47)。

结论

在这些剂量和临床条件下,褪黑素对儿童镇静无作用。

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