小儿中深度镇静失败原因回顾性分析  

Moderate and deep sedation for children： a retrospective analysis for failure reasons

作　　者：李波 陈怡绮[1] 卞勇[1] 金立红 张马忠[1] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心麻醉科,200127

出　　处：《国际麻醉学与复苏杂志》2017年第4期303-306,共4页International Journal of Anesthesiology and Resuscitation

摘　　要：目的评估小儿中深度镇静过程中可能导致镇静失败的原因，探讨进一步提高中深度镇静成功率的方法。方法收集因诊断性检查需行中深度镇静的病例48158例，其中心脏彩色多普勒检查31076例，CT检查7368例，MRI检查9714例，按照镇静流程使用水合氯醛和／或鲁米那进行中深度镇静，对镇静失败原因进行回顾性分析。结果所有纳入病例中共有4164例镇静失败，总体失败率为8．6％。其中心脏彩色多普勒、CT和MRI检查的失败率分别为7．4％、9．3％和12．2％，心脏彩色多普勒检查镇静失败率低于CT和MRI（P〈0．05）。镇静失败率随着禁食时间延长、小儿年龄增加呈升高趋势（P〈0．05）。结论多种因素可能影响镇静的效果，针对其中部分因素进行合理调整可进一步提高门诊中深度镇静的成功率。Objective The aim of this study was to evaluate the factors of failure in moderate and deep sedation in children and to improve the success rate of sedation in the future. Methods Forty-eight thousand one hundred and fifty-eight patients who failed to cooperate for painless procedures were enrolled. According to the criterion of sedation in shanghai children＇s medical center, pediatric outpatients were sedated by chloral hydrate and/or phenobarbital for procedures of echoeardiography, CT and MRI （31 076, 7 368 and 9 714）, respectively. A retrospective analysis was performed for factors which affected the rates of failure. Results There were 4 164 （8.6%） failure cases in the study. For echocardiography, CT and MRI sedation, the failure rates were 7.4%, 9.3% and 12.2% respectively. The failure rate of echocardiography was lower than CT and MRI （P〈0.05）. The failure rate of sedation had an ascending tendency with prolonged fasting time and increased age （P〈0.05）. Conclusions Multiple factors might affect the efficacy of sedation. For further improvement of success rate in moderate and deep sedation in pediatric outpatients, we should reasonably adjust and modulate some of these factors.

关 键 词：小儿 镇静 

分 类 号：R726.1[医药卫生—儿科]