[1]郑欣欣,刘剑霞,杜敏,等.右美托咪定滴鼻镇静用于小儿脑电图检查半数有效剂量的研究[J].第三军医大学学报,2018,40(14):1321-1324.
 ZHENG Xinxin,LIU Jianxia,DU Min,et al.Determination of median effective dose for intranasal dexmedetomidine sedation in children undergoing electroencephalography[J].J Third Mil Med Univ,2018,40(14):1321-1324.
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右美托咪定滴鼻镇静用于小儿脑电图检查半数有效剂量的研究(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
40卷
期数:
2018年第14期
页码:
1321-1324
栏目:
临床医学
出版日期:
2018-07-30

文章信息/Info

Title:
Determination of median effective dose for intranasal dexmedetomidine sedation in children undergoing electroencephalography
作者:
郑欣欣刘剑霞杜敏徐颖
重庆医科大学附属儿童医院麻醉科,儿童发育疾病研究教育部重点实验室,儿童发育重大疾病国家国际科技合作基地,儿科学重庆市重点实验室;重庆医科大学附属大学城医院麻醉科
Author(s):
ZHENG Xinxin LIU Jianxia DU Min XU Ying

Department of Anesthesiology,  Key Laboratory of Child Development and Disorder of Ministry of Education, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University,  Chongqing, 400014; Department of Anesthesiology, UniversityTown Hospital of Chongqing Medical University, Chongqing, 401331, China

关键词:
右美托咪定滴鼻镇静脑电图半数有效剂量儿童
Keywords:
dexmedetomidine intranasal administration sedation children electroencephalography 50% effective dose children
分类号:
R451;R741.044;R971.3
文献标志码:
A
摘要:

目的    探讨右美托咪定滴鼻镇静用于小儿脑电图检查的半数有效剂量。方法    纳入重庆医科大大学附属儿童医院2016年10月25日至2017年10月25日,拟行右美托咪定滴鼻镇静下睡眠脑电图检查患儿39例,年龄1~6岁,ASAⅠ~Ⅱ级。采用双盲、序贯的前瞻性研究方法进行试验,根据预试验结果确定初始剂量为2.0 μg/kg,将患儿Ramsay镇静评分(Ramsay sedation scale, RSS)评分≥4分和睫毛反射消失作为有效镇静标准,由上1例患儿的镇静情况,决定下1例患儿的滴鼻剂量,按0.2 μg/kg阶梯增减。将RSS评分≥4分且睫毛反射消失的患儿纳入镇静有效组,RSS评分<4分的患儿纳入镇静无效组。每10分钟记录1次患儿的呼吸频率、心率、血压和血氧饱和度,研究进行至阴性、阳性结果达到8个拐点时终止试验。结果    右美托咪定滴鼻用于小儿脑电图检查的半数有效剂量(50% effective dose,ED50)为2.10 μg/kg ,95%可信区间(confidence interval,CI)为(1.955~2.255)μg/kg。结论    2.10 μg/kg右美托咪定滴鼻可使50%脑电图检查患儿达到有效镇静状态,不干扰痫样放电检出,镇静效果满意,对呼吸和循环系统影响较小。
 

Abstract:

Objective    To determine the median effective dose (ED50) for intranasal dexmedetomidine sedation in children undergoing electroencephalographic recording. Methods    Thirty-nine children (aged 1~6 years, American Society of Anesthesiologists class Ⅰ~Ⅱ) were enrolled in this study to receive intranasal dexmedetomidine sedation for electroencephalographic recording in the Children’s Hospital of Chongqing Medical University between October 25, 2016 and October 25, 2017. This trial was conducted using a double-blind, sequential, and prospective design. According to the preliminary trial results, the starting intranasal dexmedetomidine dose was determined at 2.0 μg/kg for sedation. Effective sedation was defined as a Ramsay Sedation Scale (RSS) score of at least 4 with the loss of eyelash reflex. Based on the condition of sedation in the previous patient, the intranasal dose for the next patient was adjusted with a gradient of 0.2 μg/kg. For each child, the respiratory frequency, heart rate, blood pressure and oxygen saturation were recorded every 10 min after the sedation, and the trial was terminated when the negative and positive results reached 8 inflection points. Results    The ED50 of intranasal dexmedetomidine for sedation in children for electroencephalography was 2.10 μg/kg with a 95% confidence interval of 1.955~2.255 μg/kg. Conclusion    Intranasal administration of dexmedetomidine at the dose of 2.10 μg/kg can achieve effective sedation in 50% of the children undergoing electroencephalographic examination without interfering with the detection of epileptic discharges or producing obvious adverse effects on the respiratory and circulatory systems.

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更新日期/Last Update: 2018-07-30