Chuang E, Wenner W J, Piccoli D A, Altschuler S M, Liacouras C A
Division of Gastroenterology and Nutrition, Children's Hospital of Philadelphia, University of Pennsylvania Medical School 19104, USA.
Gastrointest Endosc. 1995 Aug;42(2):156-60. doi: 10.1016/s0016-5107(95)70073-0.
To assess the safety and efficacy of intravenous sedation in pediatric upper endoscopy, all elective outpatient procedures performed during a 2-year period (January 1, 1991 through December 31, 1992) were retrospectively reviewed. Of 614 children, 553 received intravenous meperidine and midazolam; 61 received fentanyl and midazolam. The mean dose of meperidine was 1.5 +/- 0.7 mg/kg and of fentanyl 0.0031 +/- 0.0014 mg/kg. Less midazolam was needed for children receiving fentanyl than for those receiving meperidine (0.05 +/- 0.03 mg/kg versus 0.08 +/- 0.05 mg/kg, p < 002). Recovery time (minutes) was shorter for those receiving fentanyl (74.7 +/- 22.8 versus 95.1 +/- 23.0, p < .003). Side effects occurred in 117 patients (19.1%), of which the majority were mild (83%); all were transient with no residual sequelae. Inability to complete the procedure occurred in fewer than 1%. We conclude that both combinations of medication are safe and effective for children of all ages. The use of fentanyl/midazolam results in a shorter recovery time and a lower dose of midazolam.
为评估静脉镇静用于小儿上消化道内镜检查的安全性和有效性，我们回顾性分析了在两年期间（1991年1月1日至1992年12月31日）进行的所有择期门诊手术。在614名儿童中，553名接受了静脉注射哌替啶和咪达唑仑；61名接受了芬太尼和咪达唑仑。哌替啶的平均剂量为1.5±0.7mg/kg，芬太尼的平均剂量为0.0031±0.0014mg/kg。接受芬太尼的儿童所需的咪达唑仑比接受哌替啶的儿童少（0.05±0.03mg/kg对0.08±0.05mg/kg，p<0.02）。接受芬太尼的儿童恢复时间（分钟）更短（74.7±22.8对95.1±23.0，p<0.003）。117名患者（19.1%）出现副作用，其中大多数为轻度（83%）；所有副作用均为短暂性，无残留后遗症。无法完成手术的发生率不到1%。我们得出结论，两种药物组合对各年龄段儿童均安全有效。使用芬太尼/咪达唑仑可缩短恢复时间并降低咪达唑仑剂量。
