[논문]소아 진정시 사용하는 포크랄 약물의 투여 방법 및 효율성 비교

배정아; 최윤희; 김아진; 이선화

소아 진정시 사용하는 포크랄 약물의 투여 방법 및 효율성 비교
Administration and Efficiency Comparison of Chloral Hydrate during Pediatric Sedation 원문보기

대한임상독성학회지 = Journal of the Korean society of clinical toxicology, v.14 no.1, 2016년, pp.9 - 15

배정아 (이화여자대학교 응급의학교실) , 최윤희 (이화여자대학교 응급의학교실) , 김아진 (인하대학교 의과대학 응급의학교실) , 이선화 (인제대학교 상계백병원 응급의학교실)

Abstract ▼ AI-Helper

Purpose: In most emergency department (ED), sedation is required before carrying out an invasive procedure on a pediatric patient. In the ED setting, it is essential to determine the optimal dose and administration route of CH for successful sedation. The aim of this study was to determine the optimal dose of CH for an invasive procedure and to examine the effectiveness of the drug's different administration routes. Furthermore, in this study, we performed simple survey using questionnaire which composed of Likert-scale to evaluate satisfaction of medical staffs in ED with administration routes. Methods: This study was conducted prospectively. The study participants were pediatric patients under 8 years old who visited the ED in two tertiary hospitals in South Korea within a period of 12 months. Results: Overall, 300 patients were included in this study. The age, sex, and weight of the patients were not shown to influence the sedation time. Chloral hydrate dosage is the independent factor to influence the both sedation and discharge time (p<0.01). In the comparison of the groups, groups 1, 2, and 5 showed no significant difference. On the other hand, groups 3 and 4 were shown to be statistically significantly different from group 1. Conclusion: Up to 100 mg/kg CH is safe to use in the emergency department for pediatric patients, but the initial dose of 50 mg/kg for oral administration should be considered in advance because it can provide safe and effective sedation with a lower possibility of causing an adverse effect.

주제어

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문제 정의

A survey targeting the medical staffs that perform pediatric sedation in the ED was carried out in this study. Group 2 obtained the highest score among all the groups.
The aim of this study was to examine the effectiveness of the drug's different administration routes.

가설 설정

(1) The cardiovascular function and airway patency are satisfactory and stable.
(2) The patient is easily arousable, and his/her protective reflexes are intact.

제안 방법

The aim of this study was to examine the effectiveness of the drug's different administration routes. Furthermore, in this study, we performed simple survey using questionnaire which composed of Likertscale to evaluate satisfaction of medical staffs in ED with administration routes.
In this study, the patients were divided into five groups, as follows: group 1-50 mg/kg, oral route; group 2-100 mg/kg, oral route; group 3-50 mg/kg, rectal route; group 4-100 mg/kg, rectal route; and group 5-50 mg/kg, oral route plus 50 mg/kg, rectal route. In duration of study, the patients were assigned each groups on visiting ED period of week which randomly designed. Group 1 was considered the standard group, and it was compared with the other groups in terms of drug administration dose, drug administration route, age, sex, and weight.
In this study, the patients were divided into five groups, as follows: group 1-50 mg/kg, oral route; group 2-100 mg/kg, oral route; group 3-50 mg/kg, rectal route; group 4-100 mg/kg, rectal route; and group 5-50 mg/kg, oral route plus 50 mg/kg, rectal route. In duration of study, the patients were assigned each groups on visiting ED period of week which randomly designed.
The satisfaction of the medical staff with the sedation method that was used in each group was investigated using a 5-point Likert scale questionnaire, where the higher the score was, the higher the level of satisfaction of the medical staff respondent. The questionnaire was composed of three questions including satisfaction, dissatisfaction of each method and free description of the reasons that occurred dissatisfaction.
The satisfaction of the medical staff with the sedation method that was used in each group was investigated using a 5-point Likert scale questionnaire, where the higher the score was, the higher the level of satisfaction of the medical staff respondent. The questionnaire was composed of three questions including satisfaction, dissatisfaction of each method and free description of the reasons that occurred dissatisfaction.

대상 데이터

The study participants were pediatric patients under 8 years old who visited the ED in two tertiary hospitals in South Korea. A total of 300 pediatric patients were enrolled in this study.
There were 60 patients in each group, as planned (drug administration dose/route: group 1-50 mg/kg, oral; group 2-100 mg/kg, oral; group 3-50 mg/kg, rectal; group 4-100 mg/kg, rectal; group 5-50 mg/kg, oral and rectal). Of these, 196 were male and 104 were female. The average age of patients was 28.
The baseline characteristics of the patients are presented in Table 1. Overall, 300 patients were included in this study. There were 60 patients in each group, as planned (drug administration dose/route: group 1-50 mg/kg, oral; group 2-100 mg/kg, oral; group 3-50 mg/kg, rectal; group 4-100 mg/kg, rectal; group 5-50 mg/kg, oral and rectal).
The study participants were pediatric patients under 8 years old who visited the ED in two tertiary hospitals in South Korea. A total of 300 pediatric patients were enrolled in this study.

데이터처리

The descriptive statistics of the demographic characteristics are presented herein. The demographic differences were analyzed with t-tests and chi-square tests. Multiple regression and analysis of covariance (ANCOVA) were performed to determine the statistical significance of the findings for the two groups.

성능/효과

(4) For a very young or handicapped child incapable of the usually expected responses, the pre-sedation level of responsiveness or a level as close as possible to the normal level for that child should be achieved.
2%) occurred. Both in the previous studies and in this study, vomiting was the most common adverse effect of CH, and none of the patients was reported to have manifested a severe adverse effect, including lethargy, cardiac arrhythmia, and respiratory distress. While the present study was being conducted, none of patients was revisited due to prolonged sedation, but the duration of the subconscious state after hospital discharge could not be measured.
Furthermore, for the medical staffs, the oral administration of CH is considered more comfortable and yielded a higher satisfaction rate. In this study, the reasons for dissatisfaction with a drug administration route were a longer sedation time, a longer ED stay time, a relatively high frequency of re-sedation, and a relatively high frequency of complaints from the parents due to re-sedation or prolonged stay and time to discharge. For these reasons, oral administration is thought to be an adequate sedation method as it is both effective and satisfactory for the patients, the parents of the patients, and the medical staffs.

참고문헌 (23)

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상세보기
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상세보기
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상세보기
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상세보기
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상세보기
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상세보기
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상세보기
Ronchera CL, Marti-Bonmati L, Poyatos C, Vilar J, Jimenez NV. Administration of oral chloral hydrate to paediatric patients undergoing magnetic resonance imaging. Pharm Weekbl Sci 1992;14:349-52.

상세보기
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Treluyer JM, Andre C, Carp PFC, Chalumeau M, Tonnelier S, Cuq C, et al. Sedation in children undergoing CT scan or MRI: effect of time-course and tolerance of rectal chloral hydrate. Fundam Clin Pharmacol 2004;18:347-50.

상세보기
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소아 진정시 사용하는 포크랄 약물의 투여 방법 및 효율성 비교
Administration and Efficiency Comparison of Chloral Hydrate during Pediatric Sedation 원문보기

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문제 정의

가설 설정

제안 방법

대상 데이터

데이터처리

성능/효과

참고문헌 (23)

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소아 진정시 사용하는 포크랄 약물의 투여 방법 및 효율성 비교 Administration and Efficiency Comparison of Chloral Hydrate during Pediatric Sedation 원문보기

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문제 정의

가설 설정

제안 방법

대상 데이터

데이터처리

성능/효과

참고문헌 (23)

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소아 진정시 사용하는 포크랄 약물의 투여 방법 및 효율성 비교
Administration and Efficiency Comparison of Chloral Hydrate during Pediatric Sedation 원문보기

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