德克斯梅托米丁对新生儿镇静,疼痛,呼吸系统和心血管系统的影响
Marjorie M Makoni1, Ivonne Sierra-Strum2, Adrianne R Bischoff3
1Section of Neonatal-Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA. marjorie-makoni@ouhsc.edu.
概括
德克斯梅托米丁可能会增加早产儿的心血管不稳定性,尤其是在与其他镇静剂和止痛药一起使用时. 这突显了新生儿心脏结构的脆弱性.
科学领域:
- 新生儿医学
- 儿童重症监护
- 药理学
背景情况:
- 德克斯梅托米丁在新生儿中越来越多地用于镇静和止痛.
- 了解这种脆弱群体的血液动力学影响至关重要.
研究的目的:
- 评估德克斯梅托米丁对新生儿镇静,疼痛,呼吸状况和血液动力学的影响.
- 确定与不良血液动力学事件相关的因素.
主要方法:
- 在IV级新生儿重症监护室内对206名新生儿进行持续输注的回顾性分析.
- 收集疼痛/镇静评分,血压,血管压力和内度评分 (VIS) 以及同时使用镇静剂/止痛药 (CSA) 的数据.
- 输注开始前和后24小时的数据分析.
主要成果:
- 低血压发生在26%的新生儿中,特别是早产婴儿 (<32周PMA).
- 较高的VIS和CSA与低血压有关.
- 同时使用镇静剂和止痛药 (CSA) 显著预测了血管压缩剂和异型药物的需要.
结论:
- 德克斯梅托米丁,特别是与同时服用镇静剂和止痛药 (CSA) 时,与早产婴儿的心血管不稳定性增加有关.
- 在早产新生儿中,心肌的独特结构和功能使其更容易受到伤害.
- 在此群体中使用德克斯梅托米丁时,必须对血液动力学进行仔细监测.
相关概念视频
Parenteral Anesthetics: Overview
196
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
196
Sedatives and Hypnotics Drugs: Miscellaneous Agents
236
Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
236
Stages of General Anesthesia
674
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
674
Sedatives and Hypnotics: Overview
629
Sedatives are drugs that alleviate anxiety, while hypnotics induce sleep. Both classes of medication suppress neuronal activity, leading to a calming effect for sedatives and facilitating sleep for hypnotics.
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
629
Inhalational Anesthetics: Overview
498
Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
498
Skeletal Muscle Relaxants: Adverse Effects
467
Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
Unlike...
467


