Harvard Medical School, Boston Children's Hospital, Department of Anesthesiology, Critical Care and Pain Medicine, Boston, MA, USA.
Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
Br J Anaesth. 2019 May;122(5):652-661. doi: 10.1016/j.bja.2019.01.025. Epub 2019 Mar 2.
This review offers a perspective on the future of paediatric sedation. This future will require continued evaluation of adverse events, their risk factors, and predictors. As the introduction of new sedatives with paediatric applications will remain limited, the potential role of mainstay sedatives administered by new routes, for new indications, and with new delivery techniques, should be considered. The role of non-pharmacological strategies for anxiolysis, along with the application of non-mainstay physiologic monitoring, may aid in the improvement of targeted sedation delivery. Understanding the mechanism and location of action of the different sedatives will remain an important focus. Important developments in paediatric sedation will require that large scale studies with global data contribution be conducted in order to support changes in sedation practice, improve the patient experience, and make sedation safer.
这篇综述提供了一个关于儿科镇静未来的视角。未来需要继续评估不良事件及其危险因素和预测因素。由于具有儿科应用的新型镇静剂的引入仍将受到限制，因此应考虑通过新途径、用于新适应症以及采用新传递技术来管理主要镇静剂的潜在作用。非药物性焦虑缓解策略以及非主要生理监测的应用，可能有助于改善靶向镇静传递。了解不同镇静剂的作用机制和作用部位仍将是一个重要关注点。儿科镇静领域的重要进展需要开展具有全球数据贡献的大规模研究，以支持镇静实践的改变、改善患者体验并使镇静更安全。
