非睡眠剥夺情况下水合氯醛用于眼科患儿镇静适合剂量的探讨

Exploration on appropriate sedation dose of chloral hydrate for children in ophthalmology department under non-sleep-deprived condition

目的 探讨非睡眠剥夺情况下水合氯醛用于眼科患儿镇静的适合剂量. 方法 接受眼科检查需实施镇静的患儿120例,ASAⅠ-Ⅱ级,年龄1个月-3岁. 按照年龄分为婴儿组（1-12个月）和幼儿组（1-3岁）,再按口服水合氯醛的剂量随机分为4组：婴儿1组：给予10%水合氯醛0. 5 mL/kg;婴儿2组：给予10%水合氯醛1 mL/kg;幼儿1组：给予10%水合氯醛0. 5 mL/kg;幼儿2组：给予10%水合氯醛1 mL/kg. 记录患儿服用水合氯醛后的入睡时间、入睡后脑电双频指数（ BIS）及镇静失败率. 记录实施镇静时整个过程中患儿呛咳反应、呼吸抑制及恶心呕吐等不良反应的发生情况. 结果 婴儿 1 组与婴儿 2 组比较,婴儿 2 组入睡时间缩短（P〈0. 05）,镇静失败率变化差异无统计学意义（P〉0. 05）;幼儿1组与幼儿2组比较,幼儿2组入睡时间缩短且镇静失败率降低（P〈0. 05）;各组间BIS、各项不良反应发生情况及检查时间比较差异无统计学意义（P〉0. 05）.结论 非睡眠剥夺情况下水合氯醛用于眼科婴儿的镇静适合剂量为0. 5 mL/kg,用于幼儿的适合剂量为1 mL/kg,适合剂量下均可达到满意的镇静深度,且无明显不良反应发生.

Objective To explore the appropriate dose of chloral hydrate for children in ophthalmology depart-ment under non-sleep-deprived condition. Methods One hundred and twenty cases of children,who required sedation for ophthalmologic examination with ASAⅠ~ Ⅱand aged from 1 month to 3 years were chosen. According to their a-ges,the children were divided into the infant group （1~12 months） and children group （1~3 years）,who were fur-ther randomly divided into 4 groups according to the doses of oral chloral hydrate,the infant group 1 was given 10%0. 5 mL/kg chloral hydrate,the infant group 2 was given 10% 1 mL/kg chloral hydrate,the children group 1 was given 10% 0. 5 mL/kg chloral hydrate,and the children group 2 was given 10% 1 mL/kg chloral hydrate. The sleep latency,bispectral index （ BIS ） after sleep onset and sedation failure rate were recorded after children took chloral hy-drate. During the whole process of sedation,cough reflex,respiratory depression,nausea and vomiting and other adversereactions in children were recorded. Results Compared with infant group 1,the sleep latency in the infant group 2 was reduced （P〈0. 05）,but the difference in sedation failure rate was not statistically significant （P〉0. 05）. Compared with children group 1,both the sleep latency and sedation failure rate in the children group 2 were reduced （P〈0. 05）. The differences in BIS,various adverse reactions and inspection time between different groups were not statistically sig-nificant （P〉0. 05）. Conclusion The appropriate dose of chloral hydrate for infants in ophthalmology department un-der non-sleep-deprived condition is 0. 5 mL/kg,and that for the children is 1 mL/kg. These appropriate doses are asso-ciated with satisfactory sedation degree and absence of obvious adverse reactions.