Vinsel P J, Moore G P, O'Hair K C
Emergency Medicine Residency, Darnall Army Community Hospital, Ft Hood, TX 76544.
Am J Emerg Med. 1990 May;8(3):181-3. doi: 10.1016/0735-6757(90)90317-s.
Much recent literature supports the resurgence of the intraosseous route of access in pediatrics. Intraosseous lines provide a timely noncollapsable route to the circulation in medical or traumatic emergencies when intravenous access is not possible. There has been no controlled study comparing intravenous and intraosseous loading of phenytoin. A 15 mg/kg dose of phenytoin was administered over 15 minutes to pigs by either the intravenous (n = 6) or tibial intraosseous route (n = 6). Femoral artery blood samples were drawn every 5 minutes for 35 minutes after initiation of infusion to determine phenytoin levels. There was no statistical difference between the two groups using analysis of variance repeated measures (P = .160). Microscopic examination of the cortex and marrow at the intraosseous site in these pigs was normal 5 weeks postinfusion. The authors conclude that the intraosseous route is an effective alternative to intravenous loading of phenytoin without permanent damage to the marrow.
近期许多文献都支持小儿骨内给药途径再度兴起。在医疗或创伤紧急情况下，当无法建立静脉通路时，骨内通路可为循环系统提供及时的、不可塌陷的给药途径。目前尚无比较苯妥英钠静脉给药和骨内给药的对照研究。通过静脉途径（n = 6）或胫骨骨内途径（n = 6），在15分钟内给猪注射15mg/kg剂量的苯妥英钠。输注开始后，每隔5分钟采集一次股动脉血样，持续35分钟，以测定苯妥英钠水平。采用重复测量方差分析，两组之间无统计学差异（P = 0.160）。输注后5周，对这些猪骨内注射部位的皮质和骨髓进行显微镜检查，结果正常。作者得出结论，骨内途径是苯妥英钠静脉负荷给药的有效替代方法，且不会对骨髓造成永久性损伤。
