Rautiainen P
Department of Anaesthesia, Children's Hospital, University of Helsinki, Finland.
Can J Anaesth. 1991 Nov;38(8):980-4. doi: 10.1007/BF03008615.
We have analyzed several sedation techniques for paediatric cardiac catheterization which offer stable conditions for a few hours investigation, and maintain spontaneous breathing. In the present study, after premedication with oral flunitrazepam 0.1 mg.kg-1, 14 children aged 1-17 mo were sedated with an individually titrated alfentanil infusion. Every patient was sedated to a level which produced no reaction to pain or any discomfort. The induction dose and the maintenance requirement of alfentanil were 24 +/- 8 micrograms.kg-1 and 32 +/- 8 micrograms.kg-1.hr-1 (mean +/- SD), respectively. These doses were less in cyanotic than in acyanotic patients: 21 +/- 6 vs 28 +/- 8 micrograms.kg-1 and 29 +/- 10 vs 34 +/- 3 micrograms.kg-1.hr-1, respectively (P less than 0.05). The mean plasma concentration of alfentanil during maintenance of sedation was 79 +/- 23 ng.ml-1. Ventilation of two children was assisted for a short time after an incremental bolus of alfentanil. It is concluded that an alfentanil infusion technique with close monitoring of breathing is a practical sedation method for paediatric cardiac catheterization.
我们分析了几种用于小儿心导管插入术的镇静技术，这些技术可为长达数小时的检查提供稳定条件，并维持自主呼吸。在本研究中，14名年龄在1至17个月的儿童在口服氟硝西泮0.1mg.kg-1进行术前用药后，通过个体化滴定的阿芬太尼输注进行镇静。每位患者均被镇静至对疼痛或任何不适均无反应的程度。阿芬太尼的诱导剂量和维持需求量分别为24±8微克.kg-1和32±8微克.kg-1.hr-1（平均值±标准差）。这些剂量在青紫型患者中低于非青紫型患者：分别为21±6与28±8微克.kg-1以及29±10与34±3微克.kg-1.hr-1（P<0.05）。镇静维持期间阿芬太尼的平均血浆浓度为79±23纳克.ml-1。在递增推注阿芬太尼后，有两名儿童短时间接受了辅助通气。结论是，密切监测呼吸的阿芬太尼输注技术是小儿心导管插入术一种实用的镇静方法。
