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[儿童脑计算机断层扫描中使用肌肉注射美索比妥的麻醉。附100例报告]

[Anesthesia using intramuscular methohexital for cerebral computed tomography in the child. Apropos of 100 cases].

作者信息

Bemer M, Schwindenhammer J, Pecourt E, Bertocchi M L, Poussel J F

机构信息

Département d'Anesthésie-Réanimation, C.H.R. Metz-Thionville, Hôpital Bel-Air, Thionville.

出版信息

Cah Anesthesiol. 1988 Dec;36(8):611-4.

PMID:3219635
Abstract

Computed Tomography scans of the head demand a perfect motionless state, requiring sedation or general anesthesia for young children. Taking into account that CT Scan is innocuous, the proposed method of sedation must be devoid of any risk. A study was made about one hundred cases of intramuscular methohexital sedation of children, ages 3 weeks to 6 years (average age 26.05 +/- 19.95 months and average weight 9.9 +/- 4.07 kilograms). Children's medical antecedents were heavy foetal suffering, artificial ventilation at birth time, anticonvulsant medication for thirty percent of children. Average duration of the Scan was 35.8 +/- 12 minutes, with injection of contrast material in 83 percent of children. Injection of iodized material brings on a glow of warmth that can induce withdrawal movements of the child. Contrast material is used at the dose of 2 milliliters per kilogram. In general, CT Scan is performed after a clinical examination of the child, without any premedication. The child receives methohexital saline 2.5 percent solution intramuscularly deep in outer upper quadrant of the buttock, 10 mg per kilogram-1. Once the sedation is obtained, an infusion of isotonic glucose is set on to compensate fasting. The child, spontaneously breathing, is clinically and under ECG monitoring watched over at a distance. At the end of the Scan, children are observed in the recovery ward for 46 +/- 18 minutes before going back to their ward or their parents. Intramuscular methohexital provided adequate sedation to 96 patients. Two cases of failure to achieve a motionless state required general anesthesia induced with halothane.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

头部计算机断层扫描要求患者处于完美的静止状态,因此幼儿需要使用镇静剂或全身麻醉。考虑到CT扫描并无危害,所提议的镇静方法必须毫无风险。对100例3周龄至6岁(平均年龄26.05±19.95个月,平均体重9.9±4.07千克)儿童进行了肌肉注射美索比妥镇静的研究。儿童的病史包括严重胎儿窘迫、出生时人工通气、30%的儿童使用抗惊厥药物。扫描的平均持续时间为35.8±12分钟,83%的儿童注射了造影剂。注射含碘物质会带来一阵暖意,可能诱发儿童的退缩动作。造影剂的使用剂量为每千克2毫升。一般来说,在对儿童进行临床检查后进行CT扫描,无需任何术前用药。儿童在臀部外上象限深部肌肉注射2.5%的美索比妥生理盐水溶液,剂量为每千克10毫克。一旦达到镇静效果,就开始输注等渗葡萄糖以补偿禁食。儿童自主呼吸,在临床和心电图监测下进行远程观察。扫描结束后,儿童在恢复病房观察46±18分钟,然后返回病房或其父母身边。肌肉注射美索比妥使96例患者获得了充分的镇静效果。有2例未能达到静止状态,需要用氟烷诱导全身麻醉。(摘要截断于250字)

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