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酮德克斯:小儿困难气道镇静的变革者。

Ketodex: A Game-Changer in Pediatric Sedation for Challenging Airway.

作者信息

Baptista Lidia Sofia, Pelicano Paulos Jorge, Pinto Carneiro Ana

机构信息

Anesthesiology, Unidade Local de Saúde (ULS) de Loures-Odivelas, Hospital Beatriz Ângelo, Loures, PRT.

Anesthesiology, Unidade Local de Saúde (ULS) de São José, Hospital Dona Estefânia, Lisbon, PRT.

出版信息

Cureus. 2024 Dec 18;16(12):e75959. doi: 10.7759/cureus.75959. eCollection 2024 Dec.

Abstract

Managing sedation in pediatric patients with complex facial anomalies and airway challenges requires careful consideration of safety and efficacy. This case report presents the use of the Ketodex sedation protocol, combining ketamine (NMDA receptor antagonist) and dexmedetomidine (alpha-2-agonist), for a child with a large cervical/facial mass undergoing a diagnostic magnetic resonance imaging (MRI). Ketodex provides effective sedation with minimal need for manipulation of the airway and side effects, making it ideal for cases involving difficult airways. Our protocol allows spontaneous ventilation without compromising airway reflexes and reduces airway hyperreactivity, ensuring safety in high-risk pediatric cases. Initiating sedation in a controlled environment enhances safety before moving to remote locations. The Ketodex protocol is a safe and effective choice for managing pediatric patients with challenging airways. Its use should be prioritized in controlled settings, with adaptations for individual patient needs.

摘要

对于患有复杂面部畸形和气道问题的儿科患者进行镇静管理,需要仔细考虑安全性和有效性。本病例报告介绍了Ketodex镇静方案(将氯胺酮(NMDA受体拮抗剂)和右美托咪定(α-2激动剂)联合使用)在一名患有巨大颈部/面部肿块的儿童接受诊断性磁共振成像(MRI)时的应用。Ketodex能提供有效的镇静,对气道的操作需求和副作用最小,使其成为涉及困难气道病例的理想选择。我们的方案允许自主通气,同时不损害气道反射,并降低气道高反应性,确保高危儿科病例的安全性。在进入偏远地点之前,在可控环境中开始镇静可提高安全性。Ketodex方案是管理气道具有挑战性的儿科患者的安全有效选择。应优先在可控环境中使用,并根据个体患者需求进行调整。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7e8/11654998/428df7f36f2a/cureus-0016-00000075959-i01.jpg

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