Demir Guray, Cukurova Zafer, Eren Gulay, Tekdos Yasemin, Hergunsel Oya
Tatvan State Hospital, Bitlis, Turkey.
Rev Bras Anestesiol. 2012 Jul;62(4):511-9. doi: 10.1016/S0034-7094(12)70149-6.
We aimed to investigate the effect on children undergoing Computed Tomography (CT) or Magnetic Resonance Imaging (MRI), their parents and attending anesthesiologist of "multiphase sedation" which we define as "the intended sedation level achieved with one or more agents through the same or different routes with more than one administration".
One hundred children and their parents were randomly allocated to one of two study groups. In phase 1; in Group I the patients were given midazolam (0.5mg.kg(-1)) in 5 mL fruit juice, and the ones in control group (Group II) were given only fruit juice. After intravenous (iv) cannulation; in phase II, boluses of propofol were given to achieve the adequate sedation for imaging. Anxiety scores of children and their parents were recorded using Oucher scale and STAI, respectively, and parental satisfaction was evaluated by visual analogue scale (VAS). The number of attempts for iv cannulation, length of time for preparation, and amount of hypnotics were recorded.
Anxiety state of children was similar between groups before premedication, but later it was lower in Group I. Before procedure, STAI score of parents was similar and later it was lower in Group I. Parental satisfaction in Group I was higher. The number of attempts for iv cannulation and required propofol dose was less in Group I.
"Multiphase sedation" procedure provides children to feel less pain and anxiety, and decreases parental anxiety while increasing their satisfaction. It supplies a comfortable and safe sedation, as it provides a short and problem-free preparation process for the attending anesthetist as well.
我们旨在研究“多阶段镇静”对接受计算机断层扫描（CT）或磁共振成像（MRI）的儿童、其父母以及在场麻醉医生的影响，我们将“多阶段镇静”定义为“通过相同或不同途径使用一种或多种药物进行多次给药以达到预期镇静水平”。
100名儿童及其父母被随机分配到两个研究组之一。在第一阶段，第一组患者在5毫升果汁中给予咪达唑仑（0.5毫克·千克⁻¹），而对照组（第二组）仅给予果汁。静脉置管后，在第二阶段，给予丙泊酚推注以达到成像所需的充分镇静。分别使用奥ucher量表和状态特质焦虑问卷（STAI）记录儿童及其父母的焦虑评分，并通过视觉模拟量表（VAS）评估父母的满意度。记录静脉置管的尝试次数、准备时间长度和催眠药物用量。
用药前两组儿童的焦虑状态相似，但之后第一组较低。术前，两组父母的STAI评分相似，但之后第一组较低。第一组父母的满意度较高。第一组静脉置管的尝试次数和所需丙泊酚剂量较少。
“多阶段镇静”程序可使儿童减轻疼痛和焦虑，减轻父母的焦虑并提高其满意度。它提供了舒适且安全的镇静，因为它也为在场麻醉医生提供了一个简短且无问题的准备过程。
