Department of Anaesthesiology, Guangzhou Women and Children's Medical Centre of Guangzhou Medical University, Guangzhou, China.
Anaesthesia. 2014 Mar;69(3):240-4. doi: 10.1111/anae.12533. Epub 2014 Jan 21.
Chloral hydrate is the most commonly used sedative for paediatric diagnostic procedures in China with a success rate of around 80%. Intranasal dexmedetomidine is used for rescue sedation in our centre. This prospective investigation evaluated 213 children aged one month to 10 years who were not adequately sedated following administration of chloral hydrate. Children were randomly assigned to receive rescue intranasal dexmedetomidine at 1 μg.kg(-1) (group 1), 1.5 μg.kg(-1) (group 2) or 2 μg.kg(-1) (group 3). The sedation level was assessed every 10 min using a modified observer's assessment of alertness/sedation scale. Successful rescue sedation in groups 1, 2 and 3 were 56 (83.6%), 66 (89.2%) and 51 (96.2%), respectively. Increasing the rescue dose was associated with an increased success rate with an odds ratio of 4.12 (95% CI 1.13-14.98), p = 0.032. We conclude that intranasal dexmedetomidine is effective for sedation in children who do not respond to chloral hydrate.
水合氯醛是中国儿科诊断性操作中最常用的镇静剂，成功率约为 80%。我们中心使用鼻内右美托咪定进行抢救性镇静。本前瞻性研究评估了 213 名年龄在 1 个月至 10 岁之间的儿童，这些儿童在给予水合氯醛后镇静效果不理想。儿童随机分为接受 1μg.kg(-1)（第 1 组）、1.5μg.kg(-1)（第 2 组）或 2μg.kg(-1)（第 3 组）的抢救性鼻内右美托咪定。使用改良的观察者警觉/镇静评分每 10 分钟评估一次镇静水平。第 1、2 和 3 组的抢救性镇静成功率分别为 56（83.6%）、66（89.2%）和 51（96.2%）。增加抢救剂量与成功率增加相关，优势比为 4.12（95%CI 1.13-14.98），p=0.032。我们的结论是，鼻内右美托咪定对水合氯醛无反应的儿童镇静有效。
