Nahata M C, Murray R D, Zingarelli J, Li B U, McClung H J, Lininger B
College of Pharmacy, Ohio State University, Columbus 43210.
J Pediatr Gastroenterol Nutr. 1990 Apr;10(3):335-8. doi: 10.1097/00005176-199004000-00012.
Little has been published about outpatient sedation for pediatric patients. We designed a study to evaluate the efficacy and adverse effects of diazepam and meperidine in combination for sedation in ambulatory pediatric patients undergoing endoscopy, colonoscopy, or liver biopsy. Thirty patients (7 months-20 years) were observed. Each patient received a single combined dose of intravenous diazepam and meperidine. The standard dose was 0.1 mg/kg for diazepam and 2.0 mg/kg for meperidine. In patients weighing greater than 100 lb, set doses of meperidine (100 mg) and diazepam (5 mg) were used. The time to achieve sedation and the vital signs were measured; cooperation, emotional state, and drowsiness were rated before, during, and after procedures. The amnesic effect was noted, as were any adverse effects. Diazepam and meperidine were effective in 26 of 30 patients, with sedation generally produced within 2-3 min. Cooperation and emotional state improved significantly following drug administration (p less than 0.05). When a prospective 24-h telephone follow-up study was instituted in 40 consecutive patients receiving diazepam and meperidine no significant adverse effects were noted. Only 20% of patients old enough to be questioned remembered the procedure. Diazepam and meperidine in combination appear to be effective and safe in pediatric patients undergoing gastrointestinal procedures. Prolonged monitoring of patients does not appear necessary in this patient population.
关于儿科患者门诊镇静的报道很少。我们设计了一项研究，以评估地西泮和哌替啶联合用于接受内镜检查、结肠镜检查或肝活检的非卧床儿科患者镇静的疗效和不良反应。观察了30例患者（7个月至20岁）。每位患者接受了静脉注射地西泮和哌替啶的单次联合剂量。标准剂量为地西泮0.1mg/kg，哌替啶2.0mg/kg。对于体重超过100磅的患者，使用固定剂量的哌替啶（100mg）和地西泮（5mg）。测量达到镇静的时间和生命体征；在操作前、操作期间和操作后对合作程度、情绪状态和嗜睡程度进行评分。记录遗忘效果以及任何不良反应。30例患者中有26例使用地西泮和哌替啶有效，镇静作用一般在2 - 3分钟内产生。给药后合作程度和情绪状态有显著改善（p小于0.05）。当对连续40例接受地西泮和哌替啶的患者进行前瞻性24小时电话随访研究时，未发现明显不良反应。只有20%年龄足够大可以接受询问的患者记得该操作。地西泮和哌替啶联合使用对于接受胃肠道手术的儿科患者似乎有效且安全。在该患者群体中似乎无需对患者进行长时间监测。
