Hertzog James H, Havidich Jeana E
Department of Anesthesiology and Critical Care Medicine, Alfred I duPont Hospital for Children, Wilmington, DE, USA.
Curr Opin Anaesthesiol. 2007 Aug;20(4):365-72. doi: 10.1097/ACO.0b013e32825a6a0a.
This review evaluates the past year's literature on the provision of pediatric procedural sedation outside of the operating room, especially as performed by non-anesthesiologist healthcare providers.
Research on pediatric procedural sedation practice continues to be limited by small case series and single institution study design. However, some exciting developments have occurred. Recent guideline revisions and safety initiatives are reported that impact positively on practice. Efforts to analyze the elements of sedation systems that result in greater safety, efficiency, and patient satisfaction are increasing, including evaluations of tiered systems utilizing the skills of various healthcare providers. Dexmedetomidine and etomidate are the subjects of investigation on their utility for procedural sedation. A multicentered study, adequately powered to provide meaningful evaluation of adverse events, has been completed and provides valuable insight on pediatric procedural sedation as practiced by a variety of healthcare providers.
Pediatric procedural sedation practice as performed by non-anesthesiologists continues to grow. Ongoing efforts to understand the elements of sedation systems that lead to best practice, with the subsequent development of uniform practice approaches, are essential. A collaborative relationship between anesthesiologists and non-anesthesiologist providers of procedural sedation is essential for meeting common goals.
本综述评估过去一年关于在手术室以外提供儿科程序性镇静的文献，尤其是非麻醉科医疗服务提供者所实施的情况。
儿科程序性镇静实践的研究仍然受到小病例系列和单机构研究设计的限制。然而，已经出现了一些令人兴奋的进展。报告了近期对实践产生积极影响的指南修订和安全倡议。分析导致更高安全性、效率和患者满意度的镇静系统要素的努力正在增加，包括对利用各种医疗服务提供者技能的分层系统的评估。右美托咪定和依托咪酯是其用于程序性镇静效用的研究对象。一项有足够样本量以对不良事件进行有意义评估的多中心研究已经完成，并为各种医疗服务提供者实施的儿科程序性镇静提供了有价值的见解。
非麻醉科医生实施的儿科程序性镇静实践持续增加。持续努力了解导致最佳实践的镇静系统要素，并随后制定统一的实践方法至关重要。麻醉科医生与实施程序性镇静的非麻醉科提供者之间的合作关系对于实现共同目标至关重要。
