CAJ | 학술논문

目的探讨右美托咪啶滴鼻诱导孤独症患儿行CT检查时睡眠的半数有效剂量(ED50).方法选择2013年9至12月广州市妇女儿童医疗中心拟行脑部CT检查的34例孤独症患儿为观察对象,美国麻醉师协会(ASA)Ⅰ～Ⅱ级,采用右美托咪啶滴鼻的方法诱导患儿睡眠后行CT检查.根据上1例患儿的入睡情况,按上下序贯法确定下1例患儿右美托咪啶滴鼻的剂量,以右美托咪啶滴鼻60 min内睫毛反射消失和Ramsay评分达4分或4分以上为入睡标准.出现8个阳性阴性拐点时终止研究.结果所有患儿在右美托咪啶滴鼻诱导入睡期间均未出现打喷嚏、恶心呕吐、心律失常、低血压、低氧血症等情况.研究进行至第34例患儿时出现8个阳性阴性拐点.右美托咪啶滴鼻诱导患儿睡眠的ED50为1.76 μg/kg,95％可信区间(CI)为1.64～ 1.88 μg/kg.结论右美托咪啶滴鼻用于孤独症患儿CT检查镇静安全有效,滴鼻60 min后患儿睡眠的ED50为1.76 μg/kg,95％ CI为1.64～ 1.88 μg/kg.
목적 탐토우미탁미정적비유도고독증환인행CT검사시수면적반수유효제량(ED50).방법 선택2013년9지12월엄주시부녀인동의료중심의행뇌부CT검사적34례고독증환인위관찰대상,미국마취사협회(ASA)Ⅰ～Ⅱ급,채용우미탁미정적비적방법유도환인수면후행CT검사.근거상1례환인적입수정황,안상하서관법학정하1례환인우미탁미정적비적제량,이우미탁미정적비60 min내첩모반사소실화Ramsay평분체4분혹4분이상위입수표준.출현8개양성음성괴점시종지연구.결과 소유환인재우미탁미정적비유도입수기간균미출현타분체、악심구토、심률실상、저혈압、저양혈증등정황.연구진행지제34례환인시출현8개양성음성괴점.우미탁미정적비유도환인수면적ED50위1.76 μg/kg,95％가신구간(CI)위1.64～ 1.88 μg/kg.결론 우미탁미정적비용우고독증환인CT검사진정안전유효,적비60 min후환인수면적ED50위1.76 μg/kg,95％ CI위1.64～ 1.88 μg/kg.
Objective To explore the 50％ effective dose (ED50) of dexmedetomidine nasal drip in the induction of hypnosis in children during computed tomography (CT).Methods A total of 34 American Society of Anesthesiologists (ASA) Ⅰ-Ⅱ autistic children scheduled for brain CT examination were studied.The induction was made by dexmedetomidine nasal drip and the ED50 of dexmedetomidine determined by up-and down sequential experiment.When eyelash reflex became lost or Ramsay score was ≥ 4 in 1 hour after dosing,hypnosis was achieved.The study ended after 8 crossovers (successive "accept" and "refuse").Results Among them,the ED50 of dexmedetomidine was 1.76 μg/kg (95％ confident interval:1.64-1.88 μg/kg).Conclusion The ED50 of dexmedetomidine nasal drip is 1.76 μg/kg in the induction of hypnosis in children