中国实用医药
中國實用醫藥
중국실용의약
CHINA PRACTICAL MEDICAL
2014年
28期
42-44
,共3页
孙昭%苏丹丹%杨云峰%仲素艳
孫昭%囌丹丹%楊雲峰%仲素豔
손소%소단단%양운봉%중소염
急诊%儿科学%氯胺酮%程序化镇静镇痛%眼压
急診%兒科學%氯胺酮%程序化鎮靜鎮痛%眼壓
급진%인과학%록알동%정서화진정진통%안압
Emergency%Pediatrics%Ketamine%Procedural sedation andanalgesia%Intraocular pressure
目的：探讨氯胺酮在进行程序化镇静镇痛(procedural sedation andanalgesia, PSA)中对眼压的影响。方法为对急诊室内需要氯胺酮PSA治疗患儿的前瞻性非劣效性研究,于PSA之前、氯胺酮注射后即时、2.5、5以及10 min测量并分析患者右眼眼压。结果共入组83例患者(其中49例(59%)为男性,1~5年龄组28例患者,6~10年龄组26例患者,11~15年龄组29例患者)。平均氯胺酮静脉注射总量为1.6 mg/kg(95%CI=1.4~1.7)。眼压基线均值为17.5 mm Hg(1 mm Hg=0.133 kPa)(95%CI=16.4~18.6 mm Hg),注射氯胺酮2.5 min后的眼压均值为18.9 mm Hg(95%CI=17.9~19.9 mm Hg)。其平均差为1.4 mm Hg(95%CI=0.4~2.4 mm Hg),非劣性边界为2.6 mm Hg(15%)。结论给予急诊患儿常规程序化镇静镇痛剂量的氯胺酮并没显著增加眼压。仍需更多研究来评估对于有眼部疾病患者应用氯胺酮的安全性。
目的：探討氯胺酮在進行程序化鎮靜鎮痛(procedural sedation andanalgesia, PSA)中對眼壓的影響。方法為對急診室內需要氯胺酮PSA治療患兒的前瞻性非劣效性研究,于PSA之前、氯胺酮註射後即時、2.5、5以及10 min測量併分析患者右眼眼壓。結果共入組83例患者(其中49例(59%)為男性,1~5年齡組28例患者,6~10年齡組26例患者,11~15年齡組29例患者)。平均氯胺酮靜脈註射總量為1.6 mg/kg(95%CI=1.4~1.7)。眼壓基線均值為17.5 mm Hg(1 mm Hg=0.133 kPa)(95%CI=16.4~18.6 mm Hg),註射氯胺酮2.5 min後的眼壓均值為18.9 mm Hg(95%CI=17.9~19.9 mm Hg)。其平均差為1.4 mm Hg(95%CI=0.4~2.4 mm Hg),非劣性邊界為2.6 mm Hg(15%)。結論給予急診患兒常規程序化鎮靜鎮痛劑量的氯胺酮併沒顯著增加眼壓。仍需更多研究來評估對于有眼部疾病患者應用氯胺酮的安全性。
목적：탐토록알동재진행정서화진정진통(procedural sedation andanalgesia, PSA)중대안압적영향。방법위대급진실내수요록알동PSA치료환인적전첨성비렬효성연구,우PSA지전、록알동주사후즉시、2.5、5이급10 min측량병분석환자우안안압。결과공입조83례환자(기중49례(59%)위남성,1~5년령조28례환자,6~10년령조26례환자,11~15년령조29례환자)。평균록알동정맥주사총량위1.6 mg/kg(95%CI=1.4~1.7)。안압기선균치위17.5 mm Hg(1 mm Hg=0.133 kPa)(95%CI=16.4~18.6 mm Hg),주사록알동2.5 min후적안압균치위18.9 mm Hg(95%CI=17.9~19.9 mm Hg)。기평균차위1.4 mm Hg(95%CI=0.4~2.4 mm Hg),비렬성변계위2.6 mm Hg(15%)。결론급여급진환인상규정서화진정진통제량적록알동병몰현저증가안압。잉수경다연구래평고대우유안부질병환자응용록알동적안전성。
Objective To investigate the influence of ketamine on intraocular pressure in the treatment of procedural sedation andanalgesia (PSA). Methods A prospective and non-inferiority study was made for the children needed ketamine in the treatment of PSA. The intraocular pressure of right eyes of the patients were measured before PSA, after ketamine injection immediate, and 2.5 min, 5 min, 10 min after injection. Results There were 83 patients enrolled in this study (49 cases (59%) were male, 28 cases were in 1 to 5-year-old group, 26 cases were in 6 to 10-year-old group, and 29 cases were in 11 to 15-year-old group) . The total average intravenous injection amount of ketamine was 1.6 mg/kg (95%CI=1.4~1.7). Mean value of intraocular pressure (IOP) baseline was 17.5 mmHg (1 mm Hg=0.133 kPa) (95%CI=16.4~18.6 mm Hg). Mean value of IOP baseline after ketamine injection for 2.5 min was 18.9 mmHg (95%CI=17.9~19.9 mm Hg). The average deviation was 1.4 mmHg (95%CI=0.4~2.4 mm Hg), and the non-inferiority boundary was 2.6 mmHg (15%). Conclusion Ketamine in the treatment of PSA for emergency pediatric patients does not signi-cantly increase IOP. Further study is needed for assessing its safety in patients with ocular disease.
