长期使用哌醋甲酯的睡眠障碍患者的围手术期结局

Perioperative Outcome of Dyssomnia Patients on Chronic Methylphenidate Use.

作者信息

Stoicea Nicoleta, Ellis Thomas, Moran Kenneth, Ackermann Wiebke, Wilson Thomas, Quevedo Eduardo, Bergese Sergio

机构信息

Department of Anesthesiology, Wexner Medical Center, Ohio State University, Columbus, OH.

Department of Orthopaedics, Wexner Medical Center, Ohio State University, Columbus, OH.

出版信息

J Investig Med High Impact Case Rep. 2014 Jan 29;2(1):2324709614521398. doi: 10.1177/2324709614521398. eCollection 2014 Jan-Mar.

DOI:10.1177/2324709614521398

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4528862/

Abstract

Methylphenidate is frequently prescribed for attention deficit hyperactivity disorder, narcolepsy, and other sleep disorders requiring psychostimulants. Our report is based on 2 different clinical experiences of patients with chronic methylphenidate use, undergoing general anesthesia. These cases contrast different strategies of taking versus withholding the drug treatment on the day of surgery. From the standpoint of anesthetic management and patient safety, the concerns for perioperative methylphenidate use are mainly related to cardiovascular stability and possible counteraction of sedatives and anesthetics.

摘要

哌甲酯常用于治疗注意力缺陷多动障碍、发作性睡病以及其他需要使用精神兴奋药的睡眠障碍。我们的报告基于2例长期使用哌甲酯的患者在接受全身麻醉时的不同临床经验。这些病例对比了手术当天继续用药与停药的不同策略。从麻醉管理和患者安全的角度来看，围手术期使用哌甲酯的担忧主要与心血管稳定性以及镇静药和麻醉药的可能拮抗作用有关。

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本文引用的文献

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High dose methylphenidate treatment in adult attention deficit hyperactivity disorder: a case report.高剂量哌甲酯治疗成人注意力缺陷多动障碍：一例报告

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Active emergence from propofol general anesthesia is induced by methylphenidate.哌醋甲酯可诱导丙泊酚全身麻醉后的主动苏醒。

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Ingestion of stimulant medications does not alter bispectral index or clinical depth of anesthesia at 1 MAC sevoflurane in children.在1个最低肺泡有效浓度（MAC）的七氟醚麻醉下，儿童摄入刺激性药物不会改变脑电双频指数或临床麻醉深度。

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