Stiles C M
Orthop Clin North Am. 1981 Jan;12(1):45-56.
In summary, their are a great many causes of mental retardation, each of which must be investigated carefully prior to induction of anesthesia. There are a few basic points to be remembered, no matter what the disease: (1) establish how much the patient understands and whether or not the patient can communicate, (2) establish whatever rapport is possible and use that both preoperatively and postoperatively in place of medication if possible, (3) avoid early extubation, and (4) be prepared for fairly long-term ventilation if the child cannot cooperate. The choice of anesthetic agents and preoperative and postoperative medications, their route of administration, and amount will be dictated by the disease entity, its severity, and the scope of the contemplated surgery.
总之，智力迟钝的病因众多，在麻醉诱导前必须对每一种病因进行仔细调查。无论何种疾病，都有几个基本要点需要牢记：（1）确定患者的理解能力以及是否能够交流，（2）尽可能建立融洽的关系，并在术前和术后尽可能以此代替药物治疗，（3）避免早期拔管，（4）如果患儿不能配合，则要做好长期通气的准备。麻醉药物以及术前和术后用药的选择、给药途径和剂量将取决于疾病的种类、严重程度以及预期手术的范围。
