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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
Determination of median effective dose for intranasal dexmedetomidine sedation in children undergoing electroencephalography
- 第三军医大学学报 2018年40卷第14期 页码：1321-1324
- 作者机构：
1.400014 重庆，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
2.401331 重庆，重庆医科大学附属大学城医院麻醉科
- 作者简介：
[徐颖，E-mail：xuyingxy3066@126.com XU Ying, E-mail: xuyingxy3066@126.com
- 基金信息：
DOI：10.16016/j.1000-5404.201712233
中图分类号： R451;R741.044;R971.3收稿：2017-12-25，
修回：2018-03-09，
纸质出版：2018-07-30
- 稿件说明：
移动端阅览
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.
Xinxin ZHENG, Jianxia LIU, Min DU, et al. Determination of median effective dose for intranasal dexmedetomidine sedation in children undergoing electroencephalography[J]. Journal of Third Military Medical University, 2018, 40(14): 1321-1324.
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. DOI： 10.16016/j.1000-5404.201712233.
Xinxin ZHENG, Jianxia LIU, Min DU, et al. Determination of median effective dose for intranasal dexmedetomidine sedation in children undergoing electroencephalography[J]. Journal of Third Military Medical University, 2018, 40(14): 1321-1324. DOI： 10.16016/j.1000-5404.201712233.
摘要
目的
2
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
2
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
2
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，ED
50
)为2.10 μg/kg，95%可信区间(confidence interval，
CI
)为(1.955~2.255)μg/kg。
结论
2
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
2
To determine the median effective dose (ED50) for intranasal dexmedetomidine sedation in children undergoing electroencephalographic recording.
Methods
2
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
2
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
2
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.
关键词
Keywords
references
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