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依托咪酯在小儿麻醉学中的应用:我们目前处于什么状况?

Etomidate in pediatric anesthesiology: Where are we now?

作者信息

Tobias Joseph D

机构信息

Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA ; Department of Anesthesiology and Pain Medicine, Columbus, Ohio, USA ; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA.

出版信息

Saudi J Anaesth. 2015 Oct-Dec;9(4):451-6. doi: 10.4103/1658-354X.159475.

Abstract

Etomidate is an intravenous anesthetic agent released for clinical use in the United States in 1972. Its popularity in clinical practice is the result of its beneficial effects on intracerebral dynamics with limited effects on hemodynamic function. These properties have made it a safe and effective anesthetic induction agent in both adult and pediatric patients with altered myocardial performance, congenial heart disease, or hypovolemia. However, recent concern has been expressed regarding its effects on the endogenous production of corticosteroids and the impact of that effect on patient outcomes. The following manuscript reviews clinical reports regarding etomidate use in the pediatric population and discusses recent concerns regarding its effects on corticosteroid metabolism and the implications of such effects for clinical use.

摘要

依托咪酯是一种静脉麻醉剂,于1972年在美国获批用于临床。它在临床实践中广受欢迎,是因其对脑内动力学有有益作用,而对血流动力学功能影响有限。这些特性使其成为患有心肌功能改变、先天性心脏病或血容量不足的成人和儿科患者安全有效的麻醉诱导剂。然而,最近人们对其对内源性皮质类固醇产生的影响以及该影响对患者预后的作用表示担忧。以下手稿回顾了有关依托咪酯在儿科人群中使用的临床报告,并讨论了最近对其对皮质类固醇代谢影响的担忧以及这种影响对临床使用的意义。

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