Fallah Razieh, Ferdosian Farzad, Shajari Ahmad
Pediatric Neurologist, Department of Pediatrics, Growth Disorders of Children Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Subspecialty in Pediatric Infectious Disease, Department of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Iran J Child Neurol. 2015 Summer;9(3):1-8.
Procedural sedation may be needed in many diagnostic and therapeutic procedures in children. To make pediatric procedural sedation as safe as possible, protocols should be developed by institutions. Response to sedation in children is highly variable, while some become deeply sedated after minimal doses, others may need much higher doses. Child developmental status, clinical circumstances and condition of patient should be considered and then pharmacologic and non-pharmacologic interventions for sedation be selected. Drug of choice and administration route depend on the condition of the child, type of procedure, and predicted pain degree. The drugs might be administered parenteral (intravenous or intramuscular) or non parenteral including oral, rectal, sublingual, aerosolized buccal and intranasal. The use of intravenous medication such propofol, ketamine, dexmedetomidine, or etomidate may be restricted in use by pediatric anesthesiologist or pediatric critical care specialists or pediatric emergency medicine specialists. In this review article we discuss on non-parenteral medications that can be used by non- anesthesiologist.
在儿童的许多诊断和治疗过程中可能需要实施程序性镇静。为了使儿科程序性镇静尽可能安全，各机构应制定相关方案。儿童对镇静的反应差异很大，有些人在使用极小剂量后就会深度镇静，而另一些人可能需要更高的剂量。应考虑儿童的发育状况、临床情况和患者病情，然后选择用于镇静的药物和非药物干预措施。药物的选择和给药途径取决于儿童的病情、手术类型和预计的疼痛程度。药物可以通过非肠道（静脉或肌肉注射）或非非肠道途径给药，包括口服、直肠、舌下、雾化颊部和鼻内给药。儿科麻醉医生、儿科重症监护专家或儿科急诊医学专家可能会限制使用如丙泊酚、氯胺酮、右美托咪定或依托咪酯等静脉用药。在这篇综述文章中，我们将讨论非麻醉医生可以使用的非肠道药物。
