Sanderson P M
British Columbia Children's Hospital, Vancouver, Canada.
Paediatr Anaesth. 1997;7(4):309-15. doi: 10.1046/j.1460-9592.1997.d01-91.x.
Radiologists have traditionally been responsible for the sedation of children undergoing radiological investigations. Anaesthetists are becoming increasingly involved in providing sedation and/or anaesthesia in this environment. The sedation of a child for a CT scan who has recently been given oral contrast medium (OCM) may pose anaesthetists a number of dilemmas. This is a retrospective survey of 149 intravenous pentobarbital sedations administered by radiologists to children (age range three months to seven years three months, weight range 5 kg to 28.9 kg) undergoing upper abdominal CT after recent ingestion of OCM. The average patient received pentobarbital 4.6 mg.kg-1. 141 patients (94.6%) received pentobarbital as the only sedative agent, whereas eight patients (5.4%) required supplementary sedation (midazolam +/- fentanyl). There were no failed sedations. 36 complications occurred during 22 sedations (14.7% of total), with the most common being desaturation, vomiting, airway secretions, airway obstruction, coughing and bronchospasm.
传统上,放射科医生负责对接受放射检查的儿童进行镇静。在这种情况下,麻醉医生越来越多地参与到提供镇静和/或麻醉工作中。对于最近服用了口服造影剂(OCM)的儿童进行CT扫描时的镇静,可能会给麻醉医生带来一些难题。这是一项回顾性调查,研究对象为149例由放射科医生对近期摄入OCM后接受上腹部CT检查的儿童(年龄范围为3个月至7岁3个月,体重范围为5千克至28.9千克)进行静脉注射戊巴比妥镇静的案例。平均每位患者接受了4.6毫克/千克的戊巴比妥。141例患者(94.6%)仅接受戊巴比妥作为镇静剂,而8例患者(5.4%)需要辅助镇静(咪达唑仑+/-芬太尼)。没有镇静失败的情况。在22次镇静过程中发生了36例并发症(占总数的14.7%),最常见的是血氧饱和度下降、呕吐、气道分泌物、气道阻塞、咳嗽和支气管痉挛。