在患有早产儿视网膜病变的早产儿进行激光光凝治疗期间使用镇静方案的结局评估
Assessment of Outcomes With a Sedation Protocol During Laser Photocoagulation in Preterm Infants With Retinopathy of Prematurity.
作者信息
Dannelley Jennifer F, Johnson Peter N, Anderson Michael P, Oestreich Kari, Siatkowski R Michael, Miller Jamie L
出版信息
J Pediatr Pharmacol Ther. 2018 Sep-Oct;23(5):410-416. doi: 10.5863/1551-6776-23.5.410.
OBJECTIVES
To evaluate the success of a sedation protocol of fentanyl and midazolam infusions for infants undergoing laser photocoagulation for retinopathy of prematurity.
METHODS
This retrospective study included infants receiving a sedation protocol for laser photocoagulation during a 4-year period. The primary objective was protocol success, defined as completion without interruption, absence of protocol dose deviations, and absence of interventions. Secondary objectives compared outcomes between those with and without opioid/benzodiazepine exposure. A logistic regression was used to assess the effect of prior opioid/benzodiazepine exposure on requirement for fentanyl infusion increases.
RESULTS
Twenty-six infants were included. Seven (26.9%) had protocol success. Sixteen (61.5%) had protocol success, excluding dose deviations. Seventeen (65.4%) experienced ≥1 cardiopulmonary adverse events. Photocoagulation was completed in all cases.
CONCLUSIONS
Most achieved protocol success, when eliminating dosing deviations. These data indicate that flexibility is needed in fentanyl and midazolam infusion titration, based on clinical response.
目的
评估在接受激光光凝治疗早产儿视网膜病变的婴儿中，芬太尼和咪达唑仑输注镇静方案的成功率。
方法
这项回顾性研究纳入了在4年期间接受激光光凝镇静方案的婴儿。主要目标是方案成功率，定义为无中断完成、无方案剂量偏差且无干预措施。次要目标是比较有或没有阿片类药物/苯二氮䓬类药物暴露的婴儿之间的结局。采用逻辑回归分析评估先前阿片类药物/苯二氮䓬类药物暴露对芬太尼输注增加需求的影响。
结果
纳入26例婴儿。7例（26.9%）方案成功。排除剂量偏差后，16例（61.5%）方案成功。17例（65.4%）经历了≥1次心肺不良事件。所有病例均完成了光凝治疗。
结论
排除剂量偏差后，大多数实现了方案成功。这些数据表明，根据临床反应，芬太尼和咪达唑仑输注滴定需要灵活性。
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