评估麻醉助理医师为小儿血液肿瘤患者提供的基于异丙酚的程序镇静。

IF 1.7 4区 医学 Q2 ANESTHESIOLOGY Pediatric Anesthesia Pub Date : 2025-01-01 Epub Date: 2024-10-03 DOI:10.1111/pan.15014
I van Langeveld, T Aalbers, I Prudon, R Koning, N Dors, B Hampsink, E M Bronkhorst, G J Scheffer, I Malagon, M Hendriks
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引用次数: 0

摘要

背景:腰椎穿刺和骨髓穿刺等痛苦的血液肿瘤手术需要手术镇静和镇痛。在我院,异丙酚和阿芬太尼镇静通常由麻醉助理医师提供。我们评估了由麻醉助理医师为儿童提供 PSA 项目期间发生的不良事件:我们纳入了符合麻醉助理医师深度镇静标准的儿科患者,他们计划在奈梅亨拉德布鲁德姆茨阿玛利亚儿童医院接受血液肿瘤手术。主要结果是血氧饱和度低于 92% 超过 20 秒。我们前瞻性地收集了有关人口统计学、当前健康问题、手术类型、气道干预需求和低血压的数据:我们收集了 71 名患者 437 次镇静治疗的数据。没有发生持续时间超过 20 秒、血氧饱和度低于 92% 的情况。2例患者进行了下颌推压。无需使用侵入性气道技术(口咽插管、喉罩或插管)。437 例病例中有 2 例(0.5%)平均动脉压明显下降。没有发生心肺复苏或其他不良事件,如误吸或喉痉挛:结论:在选定的儿科血液肿瘤科,经过培训并获得认证的麻醉助理医师可以按照专门的方案,安全地为短程疼痛手术提供镇静和镇痛。
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Evaluation of propofol-based procedural sedation in pediatric hemato-oncological patients provided by physician assistants in anesthesia.

Background: Procedural sedation and analgesia are required for painful hemato-oncological procedures such as lumbar and bone marrow punctures. At our institution, sedation with propofol and alfentanil is usually provided by Physician Assistants in Anesthesia. We evaluated the adverse events during the PSA program for children, provided by Physician Assistants in Anesthesia.

Patients and methods: We included pediatric patients meeting our criteria for deep sedation by a Physician Assistants in Anesthesia, scheduled for a hemato-oncological procedure at the Amalia Children's Hospital at the Radboudumc Nijmegen. The primary outcome was oxygen desaturation below 92% for more than 20 s. We prospectively collected data on demographics, current health problems, type of procedure, need for airway interventions, and hypotension.

Results: We collected data from 437 sedation sessions involving 71 patients. No oxygen desaturation below 92% lasting longer than 20 s occurred. In 2 cases, a jaw thrust was performed. No invasive airway techniques (oropharyngeal cannula, laryngeal mask, or intubation) were required. A significant drop in mean arterial pressure was seen in 2 out of 437 cases (0.5%). There was no occurrence of cardiopulmonary resuscitation or other adverse events such as aspiration or laryngeal spasm.

Conclusions: Sedation and analgesia for short painful procedures in selected pediatric hemato-oncological units with a dedicated protocol may be safely provided by trained and certified Physician Assistants in Anesthesia.

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来源期刊
Pediatric Anesthesia
Pediatric Anesthesia 医学-麻醉学
CiteScore
3.20
自引率
11.80%
发文量
222
审稿时长
3-8 weeks
期刊介绍: Devoted to the dissemination of research of interest and importance to practising anesthetists everywhere, the scientific and clinical content of Pediatric Anesthesia covers a wide selection of medical disciplines in all areas relevant to paediatric anaesthesia, pain management and peri-operative medicine. The International Editorial Board is supported by the Editorial Advisory Board and a team of Senior Advisors, to ensure that the journal is publishing the best work from the front line of research in the field. The journal publishes high-quality, relevant scientific and clinical research papers, reviews, commentaries, pro-con debates, historical vignettes, correspondence, case presentations and book reviews.
期刊最新文献
Feasibility of bispectral index monitoring during pediatric critical care transport. Ball valve gas trapping in pediatric one-lung ventilation: Not all ventilation is loss of isolation. Severe knotting guidewire after central venous catheterization. Evaluation of propofol-based procedural sedation in pediatric hemato-oncological patients provided by physician assistants in anesthesia. Perioperative intravenous lignocaine for pediatric postoperative pain-A systematic review and meta-analysis.
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