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对一家三级医疗机构中接受计算机断层扫描的儿童镇静/麻醉实践的前瞻性审计。

Prospective audit of sedation/anesthesia practices for children undergoing computerized tomography in a tertiary care institute.

作者信息

Gupta Aakriti, Sen Indu, Bhardwaj Neerja, Yaddanapudi Sandhya, Mathew Preethy J, Sahni Neeru, Bhatia Anmol

机构信息

Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

J Anaesthesiol Clin Pharmacol. 2020 Apr-Jun;36(2):156-161. doi: 10.4103/joacp.JOACP_16_19. Epub 2020 Jun 15.

Abstract

BACKGROUND AND AIMS

The aim of the study was to enumerate the sedative drugs used, assess the efficacy of sedative drugs, and determine the incidence of adverse events.

MATERIAL AND METHODS

A prospective audit of children sedated for computerized tomography (CT) by anesthesiology team was conducted for a period of 4 months. The data included patient demographic variables, fasting period, medications administered, adequacy of sedation, imaging characteristics, adverse events, and requirement for escalated care.

RESULTS

A total of 331 children were enrolled for sedation by the anesthesia team. The drugs used for sedation were propofol, ketamine, and midazolam. Twenty-two percent children received one sedative drug, 60% children were administered two drugs, and 5% children required a combination of all three drugs for successful sedation. Sedation was effective for successful conduct of CT scan in 95.8% patients without the requirement of a repeat scan. Twelve (5%) children experienced adverse events during the study period. However, none of the adverse events necessitated prolonged postprocedural hospitalization or resulted in permanent neurologic injury or death.

CONCLUSIONS

The current practice of sedation with propofol, ketamine, and midazolam, either single or in combination was efficacious in a high percentage of patients. The incidence of adverse events during the study period was low.

摘要

背景与目的

本研究旨在统计所使用的镇静药物,评估镇静药物的疗效,并确定不良事件的发生率。

材料与方法

麻醉团队对接受计算机断层扫描(CT)镇静的儿童进行了为期4个月的前瞻性审计。数据包括患者人口统计学变量、禁食时间、使用的药物、镇静效果、影像特征、不良事件以及加强护理的需求。

结果

麻醉团队共纳入331名接受镇静的儿童。用于镇静的药物有丙泊酚、氯胺酮和咪达唑仑。22%的儿童接受了一种镇静药物,60%的儿童使用了两种药物,5%的儿童需要三种药物联合使用才能成功镇静。95.8%的患者在无需重复扫描的情况下,镇静对成功进行CT扫描有效。在研究期间,12名(5%)儿童出现了不良事件。然而,没有不良事件需要延长术后住院时间,也没有导致永久性神经损伤或死亡。

结论

目前使用丙泊酚、氯胺酮和咪达唑仑单独或联合进行镇静的做法在高比例患者中是有效的。研究期间不良事件的发生率较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c26/7480298/f29489058720/JOACP-36-156-g001.jpg

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