Sedation of pediatric patients: an anesthesiologist's perspective.
Sedation of pediatric patients: an anesthesiologist's perspective.
复制标题
儿科患者的镇静：麻醉师的观点。
DOI：
10.1148/radiology.175.3.2343104
复制
发表时间：
1990
期刊：
影响因子：
19.7
通讯作者：
Dennis M. Fisher
中科院分区：
文献类型：
--
作者：
Dennis M. Fisher
需要给儿童注射镇静剂以进行放射治疗在1980年代变得司空见惯。在20世纪90年代，随着频率的增加，很可能需要镇静，特别是磁共振(MR)成像。同时，报销的限制使得麻醉科医生协助这些程序是不切实际的，患者评估、药物选择和管理以及监测的责任被放在放射科医生身上。在本期《放射学》中，Keeter等人(1)总结了他们对婴儿和儿童计算机断层扫描(CT)中的镇静实践的调查。他们指出，即使有自由的解释，临床实践也不符合美国麻醉学家协会(ASA)(2)和美国儿科学会(AAP)麻醉学部(3)建立的标准。作为一名儿科麻醉师，我被要求就推荐的做法和实际做法之间的差异发表评论。主要问题是由放射科医生给药时镇静药物的安全性。许多放射科描述了他们首选的镇静和监测方法，通常报告的并发症发生率很低(4)。这是意料之中的，因为大多数镇静药物是安全的，即使是在不太理想的条件下给药。然而，正如科恩在本期《华尔街日报》的社论(5)和其他系列(4)中所报道的那样，并发症确实会发生，有些可能相当严重。实际上，她-
T HE need to sedate children for radiologic procedures became cornmon during the i98Os. In the 1990s, sedation will likely be required with increasing frequency, particularly for magnetic resonance(MR) imaging. Concurrently, limitations on reimbursement make it impractical for anes-thesiologists to assist with these procedares, and responsibility for patient evaluation, drug selection and administration, and monitoring is placed on the radiologist. In this issue of Radiology, Keeter et al (1) summarize their survey of sedation practices in computed tomography(CT) of infants and children. They note that, even with liberal interpretation, clinical practice does not meet the standards established by the American Society of Anesthesiologists (ASA)(2) and the Section on Anesthesiology of the American Academy of Pediatrics(AAP)(3). I have been asked, as a pediatric anesthesiologist, to comment on the differences between recommended and actual practice. The major issue regards the safety of sedative drugs when administered by a radiologist. Many radiology departments have described their preferred methods of sedation and monitoring and generally report a low incidence of complications(4). This is to be expected because the majority of sedative drugs are safe, even if administered in less than optimal conditions. Yet, as reported in the editorial by Cohen(5) in this issue of the Journal and in other series (4), complications do occur, and some may be quite serious. Realistically, se-