Heard Christopher M B, Joshi Prashant, Johnson Kristin
State University of New York at Buffalo, Department of Anesthesiology and Division of Pediatric Critical Care Medicine, and Department of Pharmacy, Women and Children's Hospital of Buffalo, NY 14222, USA.
Paediatr Anaesth. 2007 Sep;17(9):888-92. doi: 10.1111/j.1460-9592.2007.02272.x.
The aim of this review was to determine whether dexmedetomidine alone provided satisfactory conditions for children undergoing magnetice resonance imaging (MRI).
A retrospective review of 21 patients was undertaken, (age range: 1-8 years, weight 10-27 kg) who received dexmedetomidine to provide deep sedation for an MRI procedure.
In the initial eight patients who received dexmedetomidine (bolus 0.5-1.5 mg.kg(-1) and infusion rate 1-1.5 mg.kg(-1).h(-1)) by itself, movement occurred in five of them, even when the maximum suggested dose was used (1 microg.kg(-1).h(-1)). Midazolam (0.1 mg.kg(-1)) i.v. was given as an adjunct to the following 13 patients (dexemdetomidine doses were lower: bolus 1 mg.kg(-1), infusion 0.5-1 mg.kg(-1).h(-1)). Only one patient moved within this group. The mean time to discharge postprocedure was 90 min. There were no differences with respect to recovery or discharge times between those who did or did not receive midazolam. No cardiac or respiratory complications were noted.
The use of dexmedetomidine for MRI sedation by itself was more unpredictable than anticipated from the published case reports of its use.
本综述的目的是确定单独使用右美托咪定是否能为接受磁共振成像（MRI）的儿童提供满意的条件。
对21例患者（年龄范围：1至8岁，体重10至27千克）进行回顾性研究，这些患者接受右美托咪定以在MRI检查过程中提供深度镇静。
最初8例单独接受右美托咪定（负荷剂量0.5至1.5毫克·千克⁻¹，输注速率1至1.5毫克·千克⁻¹·小时⁻¹）的患者中，即使使用了最大建议剂量（1微克·千克⁻¹·小时⁻¹），仍有5例出现移动。随后的13例患者静脉注射咪达唑仑（0.1毫克·千克⁻¹）作为辅助（右美托咪定剂量较低：负荷剂量1毫克·千克⁻¹，输注剂量0.5至1毫克·千克⁻¹·小时⁻¹）。该组中只有1例患者移动。术后平均出院时间为90分钟。接受或未接受咪达唑仑的患者在恢复或出院时间方面没有差异。未观察到心脏或呼吸并发症。
单独使用右美托咪定进行MRI镇静比已发表的使用病例报告所预期的更难以预测。
