Collyer Doreen, Meredith Lucy
Child Health Studies, University of Chester.
Paediatr Nurs. 2008 Feb;20(1):17-9. doi: 10.7748/paed2008.02.20.1.17.c6352.
The use of sedation and analgesia in critically ill children is necessary for clinical management but can result in undesirable side effects such as physical dependence, tolerance and withdrawal symptoms. Weaning from sedation aims to prevent such unpleasant effects. Regular scoring of signs and symptoms of withdrawal is an essential part of the weaning regime, allowing the clinician to assess whether reduced doses are causing withdrawal symptoms. However, there are wide variations in whether and how scoring systems are used. This variation may be the result of high workload, other external pressures, traditional ways of working or other factors. Strategies such as an easily accessible scoring flow chart, a poster display, improved staff induction or other measures could help to improve safety and quality in sedation management.
在危重症患儿的临床管理中，使用镇静和镇痛药物是必要的，但可能会导致身体依赖、耐受性和戒断症状等不良副作用。撤机旨在预防这些不良影响。定期对戒断的体征和症状进行评分是撤机方案的重要组成部分，可让临床医生评估剂量减少是否会引起戒断症状。然而，评分系统的使用与否及使用方式存在很大差异。这种差异可能是由于工作量大、其他外部压力、传统工作方式或其他因素导致的。诸如易于获取的评分流程图、海报展示、改进员工培训或其他措施等策略，有助于提高镇静管理的安全性和质量。
