RESUMO
The aim of this study was to compare both the behavioral and physiological effects of 2 drug regimens in children: chloral hydrate (CH), meperidine (M), and hydroxyzine (H) (regimen A) versus midazolam (MZ), M, and H (regimen B). Patients between 24 and 54 months of age were examined by crossover study design. Behavior was analyzed objectively by the North Carolina Behavior Rating System and subjectively through an operator and monitor success scale. Physiological data were recorded every 5 minutes and at critical points throughout the appointment. Sixteen patients completed this study. No significant differences in behavior were noted by the North Carolina Behavior Rating System or the operator and monitor success scale. A quiet or annoyed behavior was observed 93% and 90% of the time for regimen A and regimen B, respectively. Using the operator and monitor success scale, 63% of regimen A and 56% of regimen B sedations were successful. No statistically significant differences were noted in any of the physiological parameters between the 2 regimens. Ten episodes of hemoglobin desaturation were detected with regimen A sedations. There were no differences between the sedative drug regimens CH/M/H and MZ/M/H for behavioral outcomes or physiological parameters.
Assuntos
Analgésicos Opioides/farmacologia , Anestesia Dentária/métodos , Anestésicos Combinados/farmacologia , Anestésicos Intravenosos/farmacologia , Comportamento Infantil/efeitos dos fármacos , Hidrato de Cloral/farmacologia , Sedação Consciente/métodos , Antagonistas dos Receptores Histamínicos H1/farmacologia , Hidroxizina/farmacologia , Hipnóticos e Sedativos/farmacologia , Meperidina/farmacologia , Midazolam/farmacologia , Pré-Escolar , Estudos Cross-Over , Assistência Odontológica para Crianças/métodos , Método Duplo-Cego , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Masculino , Oxigênio/sangue , Estudos Prospectivos , Respiração/efeitos dos fármacosAssuntos
Propelentes de Aerossol/efeitos adversos , Bradicardia/induzido quimicamente , Clorofluorcarbonetos de Metano/efeitos adversos , Frequência Cardíaca/efeitos dos fármacos , Pleurodese/efeitos adversos , Talco/administração & dosagem , Propelentes de Aerossol/administração & dosagem , Aerossóis , Idoso , Temperatura Corporal/efeitos dos fármacos , Bradicardia/fisiopatologia , Clorofluorcarbonetos de Metano/administração & dosagem , Humanos , MasculinoRESUMO
Surgical patients often are receiving antiarrhythmic therapy. Thus, because anaesthetic agents can affect cardiac function and may interact with concurrent antiarrhythmic medications, the anaesthetist should be aware of the electrophysiology associated with dysrhythmias and their management. Tocainide, flecainide, mexiletine, encainide and amiodarone have been introduced recently and each has an unique pattern of bioavailability, metabolism and toxicity. Patients treated with these drugs need special concern as they have abnormal cardiovascular systems and may be at increased risk for perioperative morbidity. In addition, unexpected untoward reactions and toxicity can result from interactions of anaesthetic agents and these drugs. This review discusses normal cardiac electrophysiology, common dysrhythmias and the electrophysiological effects of the newer oral antiarrhythmic drugs.