Gakhal B, Scott C S, MacNab A J
Enderby British Columbia, Canada.
Paediatr Anaesth. 1998;8(3):229-33. doi: 10.1046/j.1460-9592.1998.00764.x.
Anaesthetists recognize that children with Down's syndrome require special management in a number of clinical situations. There is a widespread clinical impression that it is difficult to achieve adequate sedation and that, following cardiac surgery, these children require higher doses of morphine and additional sedative agents compared to patients without Down's syndrome. We conducted a retrospective chart review of 16 Down's syndrome and 16 matched non-Down's syndrome children who underwent cardiac surgery between 1984 and 1991. The average dose of morphine (continuous infusion) administered per hour was higher in the Down's syndrome group than in the non-Down's syndrome group. The difference was not statistically or clinically significant until the third postoperative day. Down's syndrome patients were more likely to still be receiving morphine on Day 3 than non-Down's patients (P < 0.05). The Down's syndrome patients were also more likely to receive additional sedatives and skeletal muscle relaxants.
麻醉医生认识到，唐氏综合征患儿在一些临床情况下需要特殊管理。临床上普遍认为，要达到足够的镇静效果很困难，而且与非唐氏综合征患者相比，这些患儿在心脏手术后需要更高剂量的吗啡和额外的镇静剂。我们对1984年至1991年间接受心脏手术的16名唐氏综合征患儿和16名匹配的非唐氏综合征患儿进行了回顾性病历审查。唐氏综合征组每小时给予的吗啡平均剂量（持续输注）高于非唐氏综合征组。直到术后第三天，这种差异在统计学或临床上都不显著。唐氏综合征患者在术后第三天仍接受吗啡治疗的可能性比非唐氏综合征患者更高（P<0.05）。唐氏综合征患者也更有可能接受额外的镇静剂和骨骼肌松弛剂。
