摘要
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.
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
出处
《中华医学杂志》
CAS
CSCD
北大核心
2014年第24期1886-1888,共3页
National Medical Journal of China
