Moderate sedation for MRI in young children with autism
Moderate sedation for MRI in young children with autism
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DOI：
10.1007/s00247-005-1499-2
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发表时间：
2005-09-01
影响因子：
2.3
通讯作者：
Piven, J
中科院分区：
文献类型：
--
作者：
Ross, AK;Hazlett, HC;Piven, J
自闭症是一种广泛的神经发育障碍。由于与自闭症相关的缺陷，自闭症儿童的镇静被认为比其他儿童的镇静更具挑战性。目的：为了验证这一假设，我们将自闭症儿童与临床对照组进行了比较，以确定MRI中中度镇静的需求差异。材料与方法：根据镇静服务方案，对18-36个月的自闭症儿童（第1组，n = 41）和无自闭症行为的儿童（第2组，n = 42）进行戊巴比妥和芬太尼联合镇静。镇静护士对所有患者保持一致，所有患者均接受镇静，以达到改良Ramsay评分4分。记录并比较人口统计学和镇静剂剂量。结果：两组均无镇静失败。第1组（自闭症）的儿童年龄明显大于第2组（32.02 +/- 3.6个月vs 28.16 +/- 6.7个月），体重明显更重（14.87 +/- 2.1 kg vs 13.42 +/- 2.2 kg）。然而，当以每公斤为基础进行比较时，第1组的芬太尼需求量显著低于第2组（1.25 +/- 0.55 mcg/kg vs 1.57 +/- 10.81 mcg/kg），但第1组和第2组之间的戊巴比妥剂量无显著差异（4.92 +/- 0.92 mg/kg vs 5.21 +/- 1.6 mg/kg）。结论：这个年龄段的自闭症儿童并不更难镇静，并且不需要更高剂量的镇静剂进行非侵入性成像研究。
Autism is a pervasive neurodevelopmental disorder. Because of the deficits associated with the condition, sedation of children with autism has been considered more challenging than sedation of other children. Objective: To test this hypothesis, we compared children with autism against clinical controls to determine differences in requirements for moderate sedation for MRI. Materials and methods: Children ages 18-36 months with autism (group 1, n = 41) and children with no autistic behavior (group 2, n = 42) were sedated with a combination of pentobarbital and fentanyl per sedation service protocol. The sedation nurse was consistent for all patients, and all were sedated to achieve a Modified Ramsay Score of 4. Demographics and doses of sedatives were recorded and compared. Results: There were no sedation failures in either group. Children in group 1 (autism) were significantly older than group 2 (32.02 +/- 3.6 months vs 28.16 +/- 6.7 months) and weighed significantly more (14.87 +/- 2.1 kg vs 13.42 +/- 2.2 kg). When compared on a per-kilogram basis, however, group 1 had a significantly lower fentanyl requirement than group 2 (1.25 +/- 0.55 mcg/kg vs 1.57 +/- 10.81 mcg/kg), but no significant difference was found in pentobarbital dosing between groups 1 and 2, respectively (4.92 +/- 0.92 mg/kg vs 5.21 +/- 1.6 mg/kg). Conclusion: Autistic children in this age range are not more difficult to sedate and do not require higher doses of sedative agents for noninvasive imaging studies.