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口服氯胺酮用于小儿镇静的疗效与安全性的叙述性综述:对当前证据的批判性分析

A Narrative Review of the Efficacy and Safety of Oral Ketamine in Pediatric Sedation: A Critical Analysis of Current Evidence.

作者信息

Dasari Lakshmi Naga Sai Sivani, Ninave Sanjot

机构信息

Anesthesia and Critical Care, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Aug 22;16(8):e67550. doi: 10.7759/cureus.67550. eCollection 2024 Aug.

Abstract

Sedation in pediatric patients presents unique challenges due to their developmental and physiological differences compared to adults. Oral ketamine, a dissociative anesthetic, has emerged as a promising alternative to traditional sedatives, offering a non-invasive method for achieving sedation in children. This comprehensive review evaluates the efficacy and safety of oral ketamine for pediatric sedation, consolidating evidence from recent studies and clinical trials. The review details the pharmacological properties of oral ketamine, including its mechanism of action and its role in achieving effective sedation. It examines dosing guidelines, clinical applications, and the outcomes of sedation procedures utilizing oral ketamine. Additionally, the review addresses the safety profile of oral ketamine, including standard and serious adverse effects, and provides recommendations for monitoring and managing potential risks. Comparative analyses with other sedation methods highlight the advantages and limitations of oral ketamine, including its effectiveness and ease of administration compared to intravenous (IV) and inhaled sedatives. The review also identifies gaps in the current literature and suggests areas for future research, including long-term safety and potential developmental impacts. In conclusion, oral ketamine represents a valuable option for pediatric sedation, offering a balance of efficacy and ease of use. This review aims to guide clinicians in making informed decisions regarding the use of oral ketamine, contributing to safer and more effective sedation practices in pediatric care.

摘要

与成人相比,儿科患者的发育和生理差异使得镇静处理面临独特挑战。口服氯胺酮作为一种解离麻醉剂,已成为传统镇静剂的一种有前景的替代方法,为实现儿童镇静提供了一种非侵入性手段。这篇综述评估了口服氯胺酮用于儿科镇静的有效性和安全性,整合了近期研究和临床试验的证据。该综述详细介绍了口服氯胺酮的药理特性,包括其作用机制以及在实现有效镇静方面的作用。它研究了给药指南、临床应用以及使用口服氯胺酮的镇静程序的结果。此外,该综述探讨了口服氯胺酮的安全性概况,包括标准和严重不良反应,并提供了监测和管理潜在风险的建议。与其他镇静方法的比较分析突出了口服氯胺酮的优缺点,包括与静脉注射(IV)和吸入性镇静剂相比其有效性和给药便利性。该综述还指出了当前文献中的空白,并提出了未来研究的领域,包括长期安全性和潜在的发育影响。总之,口服氯胺酮是儿科镇静的一个有价值的选择,在有效性和易用性之间取得了平衡。这篇综述旨在指导临床医生在使用口服氯胺酮方面做出明智的决策,有助于在儿科护理中实现更安全、更有效的镇静实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f32/11416828/55b62c0cc67a/cureus-0016-00000067550-i01.jpg

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