Gray P A, Park G R
Department of Anaesthesia, Addenbrooke's Hospital, Cambridge.
Anaesthesia. 1989 Nov;44(11):913-5. doi: 10.1111/j.1365-2044.1989.tb09147.x.
Chlormethiazole infusions were used successfully to provide night sedation for 10-19 nights in three patients with renal failure managed by continuous veno-venous haemofiltration with dialysis. Fluid overload has accompanied the use of this drug previously because of its low concentration. The ability to remove large amounts of fluid during haemofiltration dialysis proved to be effective in preventing this. All three patients had impaired liver function and showed evidence of chlormethiazole accumulation after 4-6 days. The combination of progressive reduction in dose and daily withdrawal of infusions prevented a major problem. Acceptance of this technique by the patients was high. Chlormethiazole may be a useful addition to the drugs available to provide sedation in well defined clinical circumstances.
氯美噻唑输注成功用于为3例接受连续性静脉-静脉血液滤过透析治疗的肾衰竭患者提供10至19个夜晚的夜间镇静。由于其浓度较低，此前使用该药时曾伴有液体过载情况。血液滤过透析期间大量清除液体的能力被证明可有效预防此情况。所有3例患者肝功能受损，且在4至6天后均显示有氯美噻唑蓄积迹象。逐步减少剂量并每日停止输注的联合方法预防了一个重大问题。患者对该技术的接受度很高。在明确的临床情况下，氯美噻唑可能是现有用于提供镇静作用药物的有益补充。
