Kaye Alan D, Fox Charles J, Padnos Ira W, Ehrhardt Ken P, Diaz James H, Cornett Elyse M, Chandler Debbie, Sen Sudipta, Patil Shilpadevi
Department of Anesthesiology, Louisiana State University Health Science Center, Room 659, 1542 Tulane Avenue, New Orleans, LA 70112, USA.
Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, PO Box 33932, Shreveport, LA 71130-3932, USA.
Anesthesiol Clin. 2017 Jun;35(2):e73-e94. doi: 10.1016/j.anclin.2017.01.012. Epub 2017 Apr 14.
Acute pain in the pediatric population has important differences in terms of biology, intrapopulation variation, and epidemiology. Discussion as to the pharmacologic considerations of anesthetic agents, such as induction agents, neuromuscular blockers, opioids, local anesthetics, and adjuvant agents, is presented in this article. Special considerations and concerns, such as risk for propofol infusion syndrome and adverse potential side effects of anesthesia agents, are discussed. Anesthesiologists managing pediatric patients need to have a firm understanding of physiologic and pharmacologic differences compared with the adult population. Future studies to improve the understanding of pharmacokinetics in the pediatric population are needed.
儿科人群的急性疼痛在生物学、人群内部差异和流行病学方面存在重要区别。本文讨论了麻醉药物的药理学考量,如诱导剂、神经肌肉阻滞剂、阿片类药物、局部麻醉剂和辅助药物。文中还讨论了特殊考量和关注点,如丙泊酚输注综合征的风险以及麻醉药物的潜在不良副作用。与成人相比,管理儿科患者的麻醉医生需要对生理和药理学差异有深入的理解。未来需要开展更多研究,以增进对儿科人群药代动力学的了解。