哮喘患儿在牙科治疗时用水合氯醛镇静
2016/08/31
摘要
目的：我们假设水合氯醛在轻度哮喘儿童牙科治疗中是安全、有效的镇静剂。在整个治疗过程中，我们通过测量心率的变化（HR）、经皮血氧饱和度（SpO2）、哮喘评分、行为、与水合氯醛相关的不良反应的类型和频率来评估水合氯醛安全性和效果。
材料和方法：在开放性试验中，轻度哮喘儿童（＜10岁）患者的牙科治疗在治疗前1小时接受一剂65 mg/kg的口服水合氯醛液。在整个治疗过程中评估心率（HR）、血氧饱和度、哮喘评分、行为、水合氯醛相关的不良反应的类型与频率。治疗前后对哮喘进行评分。治疗后三十分钟评估SpO2、HR、意识水平。
结果：24名儿童被纳入研究，92%（22 / 24）从镇静中恢复，无呼吸抑制。2名儿童出现轻度与水合氯醛相关的呼吸抑制。哮喘不是一个决定因素，因为他们没有经历过喘息、咳嗽、呼吸急促、或回缩。吸入氧化亚氮补充水合氯醛镇静在63%（15 / 24）的孩子中实现了有效合用。3名儿童有SpO2＜95%的情况（2个在治疗过程中，1个在恢复过程中）。
结论：水合氯醛65 mg/kg单药口服对轻度哮喘患儿接受牙科治疗时对哮喘恶化方面是安全的。由于与水合氯醛有关的镇静无效和轻微呼吸抑制，更新的、容易滴定的药物，如咪达唑仑，可能是更好的选择。
（杨冬 审校）
Eur J Paediatr Dent. 2016 Jun;17(2):141-6.
Chloral hydrate for sedation of children with asthma during dental treatment.
Abdulhamid I1, Tremblay M2, Stenger J2, Tutag Lehr V3.
Author information
Abstract
AIM:We hypothesised that chloral hydrate is safe and effective for sedation during dental treatments for children with mild asthma. We evaluated the safety and efficacy of chloral hydrate by measuring changes in heart rate (HR), transcutaneous oxygen saturation, (SpO2), asthma score, behaviour, types and frequency of adverse reactions associated with chloral hydrate were assessed throughout treatment.
MATERIALS AND METHODS:Children (<10 years old) with mild asthma undergoing dental treatments received a single 65 mg/kg oral dose of chloral hydrate liquid 1 hour prior to treatment in an open label trial. Heart rate (HR), SpO2, asthma score, behaviour, types and frequency of adverse reactions associated with chloral hydrate were assessed throughout treatment. Asthma score was obtained before and after treatment. Thirty minutes after treatment, SpO2, HR, and level of consciousness was assessed.
RESULTS:Twenty four children were enrolled and 92% (22/24) recovered from sedation without respiratory depression. Two experienced mild respiratory depression related to chloral hydrate. Asthma was not a contributing factor as they did not experience wheezing, cough, tachypnoea, or retractions. Inhaled nitrous oxide supplemented chloral hydrate sedation in 63% (15/24) children to achieve effective cooperation. Three children had a SpO2 <95% (2 during treatment, 1 during recovery).
CONCLUSION:Chloral hydrate 65 mg/kg administered a as single oral dose appears to be safe with respect to disease exacerbation for children with mild asthma undergoing dental treatment. Due to ineffective sedation and mild respiratory depression associated with chloral hydrate, newer, easily titrated medications, such as midazolam, may offer advantages.
Eur J Paediatr Dent. 2016 Jun;17(2):141-6.
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哮喘或慢性阻塞性肺疾病患者使用沙丁胺醇吸入器有或者没有集成的剂量计数器的比较效益的历史性队列研究
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