氟哌啶醇预防性用药能否降低儿童氯胺酮诱发的苏醒期谵妄？
Does haloperidol prophylaxis reduce ketamine-induced emergence delirium in children?
作者信息
Amr Mostafa A M, Shams Tarek, Al-Wadani Hamid
机构信息
Departments of Psychiatry, Mansoura University Hospital, Mansoura City, Egypt;
出版信息
Sultan Qaboos Univ Med J. 2013 May;13(2):256-62. doi: 10.12816/0003231. Epub 2013 May 9.
OBJECTIVES
Ketamine is a non-barbiturate agent with rapid action onset that induces profound sedation; however, some emergency physicians tend not to use ketamine because of the risk of emergence delirium (ED). This study aimed to evaluate the effectiveness of haloperidol prophylaxis in postoperative ketamine delirium in children.
METHODS
Prospective data relating to any emergence dreams, delirium, hallucinations, agitation, crying, altered perceptions, and necessary interventions were recorded in consecutive cases of ketamine delirium in patients attending Mansoura University Hospital, Egypt, from June 2010 to May 2011.
RESULTS
A total of 537 records were available for analysis. Of those, 267 received prophylactic haloperidol (49.7%). There were significant differences between the two groups regarding post-anaesthetic care unit behaviour. The ketamine-haloperidol groups included more patients who were sleepy, calm (P ≤0.01) and less irritable (P ≤0.01), with a lower incidence of crying (P ≤0.01) and disorientation (P ≤0.01).
CONCLUSION
We found that preoperative administration of haloperidol decreases the incidence of postoperative delirium in a sample of Egyptian children undergoing minor surgery. This is congruent with earlier work conducted in adults. This work carries great hope to decrease and even prevent ED in hospitalised, non-surgical patients.
目的
氯胺酮是一种起效迅速的非巴比妥类药物，可诱导深度镇静；然而，一些急诊医生由于存在苏醒期谵妄（ED）的风险而倾向于不使用氯胺酮。本研究旨在评估氟哌啶醇预防儿童氯胺酮术后谵妄的有效性。
方法
记录了2010年6月至2011年5月在埃及曼苏拉大学医院就诊的连续氯胺酮谵妄患者的前瞻性数据，这些数据涉及任何苏醒期梦境、谵妄、幻觉、躁动、哭闹、感知改变及必要的干预措施。
结果
共有537份记录可供分析。其中，267例接受了氟哌啶醇预防性治疗（49.7%）。两组在麻醉后护理病房的行为方面存在显著差异。氯胺酮-氟哌啶醇组中嗜睡、平静的患者更多（P≤0.01），烦躁的患者更少（P≤0.01），哭闹（P≤0.01）和定向障碍（P≤0.01）的发生率更低。
结论
我们发现，在接受小手术的埃及儿童样本中，术前给予氟哌啶醇可降低术后谵妄的发生率。这与早期在成人中进行的研究结果一致。这项工作为降低甚至预防住院非手术患者的ED带来了很大希望。
Zotero 插件