Intravenous clonidine infusion in critically ill children: dose-dependent sedative effects and cardiovascular stability

被引：52

作者：

Ambrose, C ^{[1
]}

Sale, S ^{[1
]}

Howells, R ^{[1
]}

Bevan, C ^{[1
]}

Jenkins, I ^{[1
]}

Weir, P ^{[1
]}

Murphy, P ^{[1
]}

Wolf, A ^{[1
]}

机构：

[1] Royal Hosp Sick Children, Paediat Intens Care Unit, Bristol BS2 8BJ, Avon, England

来源：

BRITISH JOURNAL OF ANAESTHESIA | 2000年 / 84卷 / 06期

关键词：

anaesthesia; paediatrics; hypnotics; measurement techniques; cardiac output;

D O I：

10.1093/oxfordjournals.bja.a013594

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Clonidine is used for analgesia and sedation in paediatric anaesthesia, but there are no data on its sedative properties and side effects in critically ill children. We studied 30 ventilated children aged 10 yr and under to determine an effective i.v. dosing range and to assess its cardiovascular effects. Twenty non-paralysed, ventilated children were given a background infusion of midazolam 50 mu g kg(-1) h(-1) combined with a variable clonidine infusion (0.1-2 mu g kg(-1) h(-1)) to maintain optimal sedation. The effects of clonidine 1 mu g kg(-1) h(-1) on cardiac index were measured in 10 postoperative cardiac patients using a reverse Fick method. Dose-dependent sedation was achievable (713 out of 861 h) without cardiovascular side effects, but an infusion limit of clonidine 1 mu g kg(-1) h(-1) was inadequate in two patients. An increased dose limit of 2 mu g kg(-1) h(-1) combined with midazolam 50 mu g kg(-1) h(-1) achieved satisfactory sedation scores for 602 out of a total of 672 h studied with no failures. Clonidine in combination with midazolam at 1 mu g kg(-1) h(-1) was not associated with significant changes in heart rate arterial pressure or cardiac index.

引用

页码：794 / 796

页数：3

共 6 条

[1] REAL-TIME GAS-EXCHANGE MEASUREMENT OF OXYGEN-CONSUMPTION IN NEONATES AND INFANTS AFTER CARDIAC-SURGERY [J].

CHANG, AC ;

KULIK, TJ ;

HICKEY, PR ;

WESSEL, DL .

CRITICAL CARE MEDICINE, 1993, 21 (09) :1369-1375

[2] COMPARISON OF CAUDAL AND ILIOINGUINAL ILIOHYPOGASTRIC NERVE BLOCKS FOR CONTROL OF POST-ORCHIOPEXY PAIN IN PEDIATRIC AMBULATORY SURGERY [J].

HANNALLAH, RS ;

BROADMAN, LM ;

BELMAN, AB ;

ABRAMOWITZ, MD ;

EPSTEIN, BS .

ANESTHESIOLOGY, 1987, 66 (06) :832-834

[3] ALPHA-2 ADRENOCEPTOR AGONISTS - DEFINING THE ROLE IN CLINICAL ANESTHESIA [J].

MAZE, M ;

TRANQUILLI, W .

ANESTHESIOLOGY, 1991, 74 (03) :581-605

[4] SEDATION FOR THE CRITICALLY ILL NEUROLOGIC PATIENT [J].

MIRSKI, MA ;

MUFFELMAN, B ;

ULATOWSKI, JA ;

HANLEY, DF .

CRITICAL CARE MEDICINE, 1995, 23 (12) :2038-2053

[5]

MISHINA K, 1999, PAEDIATR ANAESTH, V9, P187

[6]

WOLF AR, 1999, TXB NEONATOLOGY, P435

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