1
|
Chen H, Yang F, Ye M, Liu H, Zhang J, Tian Q, Liu R, Yu Q, Li S, Tu S. Intranasal dexmedetomidine is an effective sedative agent for electroencephalography in children. BMC Anesthesiol 2020; 20:61. [PMID: 32145737 PMCID: PMC7060610 DOI: 10.1186/s12871-020-00978-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 03/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intranasal dexmedetomidine (DEX), as a novel sedation method, has been used in many clinical examinations of infants and children. However, the safety and efficacy of this method for electroencephalography (EEG) in children is limited. In this study, we performed a large-scale clinical case analysis of patients who received this sedation method. The purpose of this study was to evaluate the safety and efficacy of intranasal DEX for sedation in children during EEG. METHODS This was a retrospective study. The inclusion criteria were children who underwent EEG from October 2016 to October 2018 at the Children's Hospital affiliated with Chongqing Medical University. All the children received 2.5 μg·kg- 1 of intranasal DEX for sedation during the procedure. We used the Modified Observer Assessment of Alertness/Sedation Scale (MOAA/S) and the Modified Aldrete score (MAS) to evaluate the effects of the treatment on sedation and resuscitation. The sex, age, weight, American Society of Anesthesiologists physical status (ASAPS), vital signs, sedation onset and recovery times, sedation success rate, and adverse patient events were recorded. RESULTS A total of 3475 cases were collected and analysed in this study. The success rate of the initial dose was 87.0% (3024/3475 cases), and the success rate of intranasal sedation rescue was 60.8% (274/451 cases). The median sedation onset time was 19 mins (IQR: 17-22 min), and the sedation recovery time was 41 mins (IQR: 36-47 min). The total incidence of adverse events was 0.95% (33/3475 cases), and no serious adverse events occurred. CONCLUSIONS Intranasal DEX (2.5 μg·kg- 1) can be safely and effectively used for EEG sedation in children.
Collapse
Affiliation(s)
- Hang Chen
- Department of Anesthesiology, Children's Hospital of Chongqing Medical University, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, People's Republic of China
| | - Fei Yang
- Department of Anesthesiology, Children's Hospital of Chongqing Medical University, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, People's Republic of China
| | - Mao Ye
- Department of Anesthesiology, Children's Hospital of Chongqing Medical University, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, People's Republic of China
| | - Hui Liu
- Department of Anesthesiology, Children's Hospital of Chongqing Medical University, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, People's Republic of China
| | - Jing Zhang
- Department of Anesthesiology, Children's Hospital of Chongqing Medical University, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, People's Republic of China
| | - Qin Tian
- Department of Anesthesiology, Children's Hospital of Chongqing Medical University, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, People's Republic of China
| | - Ruiqi Liu
- Department of Anesthesiology, Children's Hospital of Chongqing Medical University, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, People's Republic of China
| | - Qing Yu
- Department of Anesthesiology, Children's Hospital of Chongqing Medical University, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, People's Republic of China
| | - Shangyingying Li
- Department of Anesthesiology, Children's Hospital of Chongqing Medical University, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, People's Republic of China
| | - Shengfen Tu
- Department of Anesthesiology, Children's Hospital of Chongqing Medical University, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, People's Republic of China.
| |
Collapse
|
2
|
Jia L, Hou J, Zheng H, Sun L, Fan Y, Wang X, Hao M, Li Y, Yang T. Study of the rational dose of propofol in elderly patients under bispectral index monitoring during total intravenous anesthesia: A PRISMA-compliant systematic review. Medicine (Baltimore) 2020; 99:e19043. [PMID: 32000452 PMCID: PMC7004673 DOI: 10.1097/md.0000000000019043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Propofol has been used widely as an anesthetic for elderly patients; however, the drug instructions only indicate that the need for maintenance of general anesthesia in elderly patients is reduced, and not the extent of the reduction. This study has summarized the usage of propofol in total intravenous anesthesia under bispectral index (BIS) monitoring and determined the optimum dosage of propofol for elderly patients. METHODS The study comprised 156 patients undergoing elective surgery under general anesthesia divided into 2 groups according to their age: the elderly group (O group) and nonelderly group (Y group). BIS monitoring was used in both groups during the operation, and propofol and remifentanil were used to maintain anesthesia. The preoperative special conditions, intraoperative maintenance of propofol, remifentanil, fentanyl, cis-atracurium, vasoactive drug use, and hemodynamic changes were summarized. RESULTS Propofol maintenance in the O group was 3.372 ± 0.774 mg/(kg h), which was significantly lesser than that in Y group (P < 0.05). The incidence of cardiovascular and cerebrovascular diseases and the use rate of vasoactive drugs in the O group were significantly higher than in the Y group (P < 0.05). CONCLUSION Propofol maintenance in the O group was significantly lower than that in the nonelderly group; this indicates that the anesthetic drug delivery rate for elderly patients should be reduced.
Collapse
Affiliation(s)
| | - Jiachen Hou
- Department of Surgery, the Second Hospital of Jilin University, Changchun City, Jilin Province, China
| | | | | | | | - Xu Wang
- Department of Anesthesiology
| | | | - Yue Li
- Department of Anesthesiology
| | | |
Collapse
|