Cole Jon B, Klein Lauren R, Strobel Ashley M, Blanchard Stephane R, Nahum Rebecca, Martel Marc L
From the Department of Emergency Medicine, Hennepin County Medical Center.
University of Minnesota Medical School, Minneapolis, MN.
Pediatr Emerg Care. 2020 Feb;36(2):70-76. doi: 10.1097/PEC.0000000000001231.
Olanzapine is a second-generation antipsychotic increasingly used in emergency medicine for many indications. Literature on its use in children is sparse. Our objectives were to describe the use, safety, and efficacy of olanzapine in pediatric emergency patients.
A structured chart review was performed of patients 18 years old or younger receiving olanzapine from 2007 to 2016 in the emergency department of a pediatric level I trauma center.
A total of 285 children received olanzapine. Mean age was 16.4 years (range, 9-18 years); 121 were male (42.8%). Primary indications for olanzapine included agitation (n = 166, 58.3%), headache (n = 58, 20.4%), nausea/vomiting/abdominal pain (n = 37, 12.5%), unspecified pain (n = 20, 7%), and other (n = 4, 1.4%). Route of olanzapine administration was intramuscular (n = 160, 56%; median dose, 10 mg; range, 2.5-20), intravenous (n = 101, 36%; median dose, 5 mg; range, 1.25-5), and oral (n = 24, 8%; median dose, 10 mg; range, 5-10). For agitated patients, 28 (17%) received another sedative within 1 hour. For headache patients, 5 (8.6%) received another analgesic. For gastrointestinal complaints, 5 patients (13.5%) received another analgesic/antiemetic. Adverse respiratory events were hypoxia (pulse oximetry reading, in percentage, <92%; n = 7, 2.4%), supplemental oxygen placement (n = 9, 3.2%), and intubation (n = 2, 0.7%). No patient died or had a dysrhythmia. One patient experienced dystonia.
Olanzapine seems safe when used for a variety of conditions in pediatric emergency patients. It may be effective for acute agitation, primary headache, and gastrointestinal complaints.
奥氮平是一种第二代抗精神病药物，在急诊医学中越来越多地用于多种适应症。关于其在儿童中使用的文献很少。我们的目的是描述奥氮平在儿科急诊患者中的使用情况、安全性和有效性。
对2007年至2016年期间在一级儿科创伤中心急诊科接受奥氮平治疗的18岁及以下患者进行结构化图表回顾。
共有285名儿童接受了奥氮平治疗。平均年龄为16.4岁（范围9 - 18岁）；121名男性（42.8%）。奥氮平的主要适应症包括躁动（n = 166，58.3%）、头痛（n = 58，20.4%）、恶心/呕吐/腹痛（n = 37，12.5%）、未明确的疼痛（n = 20，7%）和其他（n = 4，1.4%）。奥氮平的给药途径为肌肉注射（n = 160，56%；中位剂量，10 mg；范围，2.5 - 20）、静脉注射（n = 101，36%；中位剂量，5 mg；范围，1.25 - 5）和口服（n = 24，8%；中位剂量，10 mg；范围，5 - 10）。对于躁动患者，28名（17%）在1小时内接受了另一种镇静剂。对于头痛患者，5名（8.6%）接受了另一种镇痛药。对于胃肠道不适患者，5名（13.5%）接受了另一种镇痛药/止吐药。不良呼吸事件包括低氧血症（脉搏血氧饱和度读数百分比<92%；n = 7，2.4%）、吸氧（n = 9，3.2%）和插管（n = 2，0.7%）。没有患者死亡或发生心律失常。1名患者出现肌张力障碍。
奥氮平用于儿科急诊患者的多种病症时似乎是安全的。它可能对急性躁动、原发性头痛和胃肠道不适有效。
