Finnemore Anna, Toulmin Hilary, Merchant Naz, Arichi Tom, Tusor Nora, Cox David, Ederies Ash, Nongena Phumza, Ko Christopher, Dias Ryan, Edwards Anthony D, Groves Alan M
Centre for the Developing Brain, Imperial College London and MRC Clinical Sciences Centre, London, UK.
Paediatr Anaesth. 2014 Feb;24(2):190-5. doi: 10.1111/pan.12264. Epub 2013 Sep 24.
The aim of this study was to look for clinically significant adverse effects of chloral hydrate used in a large cohort of infants sedated for magnetic resonance imaging.
Case notes of infants who underwent magnetic resonance imaging (MRI) scanning from 2008 to 2010 were reviewed, with patient demographics, sedation dose, comorbidities, time to discharge, and side effects of sedation noted.
Four hundred and eleven infants (median [range] postmenstrual age per weight at scan 42 [31(+4) -60] weeks per 3500 g [1060-9900 g]) were sedated with chloral hydrate (median [range] dose 50 [20-80] mg·kg(-1)). In three cases (0.7%), desaturations occurred which prompted termination of the scan. One infant (0.2%) was admitted for additional observation following sedation but had no prolonged effects. In 17 (3.1%) cases, infants had desaturations which were self-limiting or responded to additional inspired oxygen such that scanning was allowed to continue.
When adhering to strict protocols, MRI scanning in newborn infants in this cohort was performed using chloral hydrate sedation with a relatively low risk of significant adverse effects.
本研究旨在探寻水合氯醛用于大量因磁共振成像而接受镇静的婴儿时的临床显著不良反应。
回顾了2008年至2010年接受磁共振成像(MRI)扫描的婴儿病历,记录了患者人口统计学信息、镇静剂量、合并症、出院时间及镇静副作用。
411名婴儿(扫描时按体重计算的月经后年龄中位数[范围]为每3500克[1060 - 9900克]42[31(+4)- 60]周)接受了水合氯醛镇静(剂量中位数[范围]为50[20 - 80]毫克·千克⁻¹)。3例(0.7%)出现饱和度下降,促使扫描终止。1例婴儿(0.2%)在镇静后入院接受进一步观察,但未产生长期影响。17例(3.1%)婴儿出现饱和度下降,为自限性或对额外吸氧有反应,从而得以继续扫描。
在遵循严格方案的情况下,该队列中的新生儿使用水合氯醛镇静进行MRI扫描时,出现显著不良反应的风险相对较低。