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鼻内给予右美托咪定用于小儿程序性镇静的镇静剂

Intranasal Dexmedetomidine as a Sedative for Pediatric Procedural Sedation.

作者信息

Behrle Natalie, Birisci Esma, Anderson Jordan, Schroeder Sara, Dalabih Abdallah

出版信息

J Pediatr Pharmacol Ther. 2017 Jan-Feb;22(1):4-8. doi: 10.5863/1551-6776-22.1.4.

Abstract

OBJECTIVE

This study seeks to evaluate the efficacy and safety of intranasal (IN) dexmedetomidine as a sedative medication for non-invasive procedural sedation.

METHODS

Subjects 6 months to 18 years of age undergoing non-invasive elective procedures were included. Dexmedetomidine (3 mcg/kg) was administered IN 40 minutes before the scheduled procedure time. The IN dexmedetomidine cohort was matched and compared to a cohort of 690 subjects who underwent sedation for similar procedures without the use of dexmedetomidine to evaluate for observed events/interventions and procedural times.

RESULTS

One hundred (92%) of the 109 included subjects were successfully sedated with IN dexmedetomidine. There were no significant differences in the rate of observed events/interventions in comparison to the non-dexmedetomidine cohort. However, the IN dexmedetomidine group had a longer postprocedure sleep time when compared to the non-dexmedetomidine cohort (p < 0.001), which had a significant effect on recovery time (p = 0.024). Also, the dexmedetomidine cohort had longer procedure time and total admit time (p < 0.001 and p = 0.037, respectively).

CONCLUSIONS

IN dexmedetomidine may be used for non-invasive pediatric procedural sedation. Subjects receiving IN dexmedetomidine had a similar rate of observed events/interventions as the subjects receiving non-dexmedetomidine sedation, with the exception of sleeping time. Also, patients sedated with IN dexmedetomidine had longer time to discharge, procedure time, and total admit time in comparison to other forms of sedation.

摘要

目的

本研究旨在评估鼻内给予右美托咪定作为非侵入性操作镇静用药的有效性和安全性。

方法

纳入6个月至18岁接受非侵入性择期手术的受试者。在预定手术时间前40分钟经鼻给予右美托咪定(3微克/千克)。将经鼻给予右美托咪定的队列与690名接受类似手术但未使用右美托咪定进行镇静的受试者队列进行匹配和比较,以评估观察到的事件/干预措施及手术时间。

结果

109名纳入研究的受试者中有100名(92%)经鼻给予右美托咪定后成功镇静。与未使用右美托咪定的队列相比,观察到的事件/干预措施发生率无显著差异。然而,与未使用右美托咪定的队列相比,经鼻给予右美托咪定的组术后睡眠时间更长(p < 0.001),这对恢复时间有显著影响(p = 0.024)。此外,右美托咪定组的手术时间和总住院时间更长(分别为p < 0.001和p = 0.037)。

结论

经鼻给予右美托咪定可用于儿科非侵入性操作镇静。接受经鼻给予右美托咪定的受试者观察到的事件/干预措施发生率与接受未使用右美托咪定镇静的受试者相似,但睡眠时间除外。此外,与其他形式的镇静相比,经鼻给予右美托咪定镇静的患者出院时间、手术时间和总住院时间更长。

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