危重患儿的镇静及镇痛

被引:16
作者
杨自建
机构
[1] 复旦大学儿科医院 PICU
[2] 上海
关键词
清醒镇静; 镇痛; 危重病人医疗;
D O I
暂无
中图分类号
R725.05 [];
学科分类号
摘要
儿科重症监护病房(PICU)中的患儿由于疾病本身及特殊的环境往往发生应激反应,直接影响患儿的预后。研究表明,在PICU进行镇静、镇痛治疗是安全的。在进行镇静、镇痛治疗前应首先进行疼痛、镇静评估。疼痛的评估分为自述、行为观察、生理测量三种方法,应根据患儿的年龄及认知水平选择相应的方法。目前阿片类药物仍然是镇痛的主要药物,异丙酚及苯二氮(艹卓)类药物是镇静的主要药物。心理行为疗法是有效的辅助疗法,对肿瘤晚期患儿可以进行局床及神经阻断疗法。
引用
收藏
页码:193 / 196
页数:4
相关论文
共 11 条
[1]   Auditory evoked potential index predicts the depth of sedation and movement in response to skin incision during sevoflurane anesthesia [J].
Kurita, T ;
Doi, M ;
Katoh, T ;
Sano, H ;
Sato, S ;
Mantzaridis, H ;
Kenny, GNC .
ANESTHESIOLOGY, 2001, 95 (02) :364-370
[2]   Pain assessment in infants and children [J].
Franck, LS ;
Greenberg, CS ;
Stevens, B .
PEDIATRIC CLINICS OF NORTH AMERICA, 2000, 47 (03) :487-+
[3]  
Does midazolam alter the clinical effects of intravenous ketamine sedation in children? A double-blind, randomized, controlled, emergency department trial[J] . Joe E. Wathen,Mark G. Roback,Todd Mackenzie,Joan P. Bothner.Annals of Emergency Medicine . 2000 (6)
[4]   Assessing sedation during intensive care unit mechanical ventilation with the Bispectral Index and the Sedation-Agitation Scale [J].
Simmons, LE ;
Riker, RR ;
Prato, BS ;
Fraser, GL .
CRITICAL CARE MEDICINE, 1999, 27 (08) :1499-1504
[5]  
Advantages of fentanyl over morphine in analgesia for ventilated newborn infants after birth: A randomized trial[J] . The Journal of Pediatrics . 1999 (2)
[6]   Adverse events of procedural sedation and analgesia in a pediatric emergency department [J].
Peña, BMG ;
Krauss, B .
ANNALS OF EMERGENCY MEDICINE, 1999, 34 (04) :483-491
[7]   A cost analysis of enterally administered lorazepam in the pediatric intensive care unit [J].
Lugo, RA ;
Chester, EA ;
Cash, J ;
Grant, MJC ;
Vernon, DD .
CRITICAL CARE MEDICINE, 1999, 27 (02) :417-421
[8]   Occurrence of withdrawal in critically ill sedated children [J].
Fonsmark, L ;
Rasmussen, YH ;
Carl, P .
CRITICAL CARE MEDICINE, 1999, 27 (01) :196-199
[9]   Complications of sedation with midazolam in the intensive care unit and a comparison with other sedative regimens [J].
Shafer, A .
CRITICAL CARE MEDICINE, 1998, 26 (05) :947-956
[10]   Comparison of ketamine and dextromethorphan in potentiating the antinociceptive effect of morphine in rats [J].
Plesan, A ;
Hedman, U ;
Xu, XJ ;
Wiesenfeld-Hallin, Z .
ANESTHESIA AND ANALGESIA, 1998, 86 (04) :825-829