右美托咪定和瑞芬太尼用于新生儿开胸手术及先天性囊性腺瘤样畸形切除术的全身麻醉
General Anesthesia With Dexmedetomidine and Remifentanil in a Neonate During Oracotomy and Resection of a Congenital Cystic Adenomatoid Malformation.
作者信息
Cappuccio Ellise, Thung Arlyne K, Tobias Joseph D
出版信息
J Pediatr Pharmacol Ther. 2018 May-Jun;23(3):215-218. doi: 10.5863/1551-6776-23.3.215.
Abstract
Based on animal data, concern has been expressed regarding the potential deleterious neurocognitive effects of general anesthesia during infancy and early life. Although there are no definitive data to prove this effect, the neonatal period has been suggested to be the most vulnerable period. While various inhaled and intravenous anesthetic agents have been implicated, dexmedetomidine and the opioids may be devoid of such effects. However, there are limited data regarding the combination of these agents during neonatal surgery and anesthesia. We present the use of these agents in combination with epidural anesthesia for postoperative analgesia in a 1-day-old neonate during thoracotomy and excision of a congental cystic adenomatoid malformation. Previous reports of the use of this unique combination of agents are reviewed and their role in this scenario discussed.
摘要
基于动物数据，人们对婴儿期和生命早期全身麻醉可能产生的有害神经认知影响表示担忧。尽管尚无确凿数据证明这种影响，但新生儿期被认为是最脆弱的时期。虽然各种吸入性和静脉麻醉剂都被认为与此有关，但右美托咪定和阿片类药物可能没有这种影响。然而，关于这些药物在新生儿手术和麻醉期间联合使用的数据有限。我们介绍了在一名1日龄新生儿开胸手术和切除先天性囊性腺瘤样畸形时，将这些药物与硬膜外麻醉联合用于术后镇痛的情况。回顾了以前关于使用这种独特药物组合的报道，并讨论了它们在这种情况下的作用。
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