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[肌内注射美索比妥。一种用于儿童脑部计算机断层扫描的简单可靠的镇静方法]

[Intramuscular methohexital. A simple and reliable means of sedation for cerebral computed tomography in children].

作者信息

Schoch J P, Robert R, Ramboatiana R, Gassner C, Tartary D, Vulliod D, Glele J, Tuefferd N, Houssier F

机构信息

Département d'anesthésie-réanimation, Centre hospitalier général de Montbeliard.

出版信息

Agressologie. 1990 Jan;31(1):45-8.

PMID:2363480
Abstract

Intramuscular methohexital sedation was retained as an easy and reliable method to sedate children for a C.T. scan. In this retrospective study of 50 cases of children aged from 2 months to 7 years all the children were administrated an oral premedication (diazepam: 1 drop/kg and atropine: 0.02 mg.kg-1) one hour before the scanner examination. Once in the operating room, they were administrated 10 mg.kg-1 methohexital saline 2.5% solution, intramuscularly deep in the buttock. E.C.G. was the main monitoring. Spontaneous breathing was evidenced by means of a simple device. At the end of the scan, the child was taken care for in the recovery room. The methohexital dose provided adequate sedation in most cases. Once the injection was given, a motionless state was reached in 4.20 minutes. The insertion of an intravenous catheter induced movements in 96% cases, which did not interfere with the successful intravenous puncture. In 33% cases, 1 to 2 mg.kg-1 ketamine was necessary because of a failed attempt at obtaining the required state, or of an awakening due to iodized injection. Among those cases, half the children were overweight for their ages. In this situation an adjusting dose should be considered. On average, a child under the influence of the drug slept for 35 minutes and the required time for a C.T. scan is 23.3 minutes. Time in the recovery room is on average 20 minutes. There was no episode of cardiovascular or respiration failure, or local reaction at the injection site. There was also no episode of seizure.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

肌肉注射美索比妥镇静作为一种简单可靠的方法,用于使儿童在进行CT扫描时镇静。在这项对50例年龄从2个月至7岁儿童的回顾性研究中,所有儿童在扫描检查前1小时口服术前用药(地西泮:1滴/千克,阿托品:0.02毫克/千克)。一旦进入手术室,他们在臀部深部肌肉注射2.5%的美索比妥生理盐水溶液,剂量为10毫克/千克。以心电图作为主要监测手段。通过一个简单装置证实有自主呼吸。扫描结束后,患儿在恢复室接受护理。在大多数情况下,美索比妥剂量提供了足够的镇静效果。注射后,在4.20分钟内达到静止状态。插入静脉导管在96%的病例中引起了活动,但这并未干扰静脉穿刺的成功进行。在33%的病例中,由于未能达到所需状态或因注射造影剂而苏醒,需要1至2毫克/千克的氯胺酮。在这些病例中,一半的儿童年龄别体重超重。在这种情况下应考虑调整剂量。平均而言,受药物影响的儿童睡眠35分钟,而CT扫描所需时间为23.3分钟。在恢复室的平均时间为20分钟。没有发生心血管或呼吸衰竭事件,也没有注射部位的局部反应。也没有癫痫发作事件。(摘要截选至250字)

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