Anxiety in Children Undergoing VCUG Sedation or No Sedation英文文献资料.docVIP

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Anxiety in Children Undergoing VCUG Sedation or No Sedation英文文献资料.doc

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Anxiety in Children Undergoing VCUG Sedation or No Sedation英文文献资料

HindawiPublishingCorporation AdvancesinUrology Volume2008,ArticleID498614,12pages doi:10.1155/2008/498614 ReviewArticle AnxietyinChildrenUndergoingVCUG: SedationorNoSedation? DavidW.Herd DepartmentofPaediatrics,StarshipChildren’sHospital,UniversityofAuckland,PrivateBag92024,Auckland,NewZealand CorrespondenceshouldbeaddressedtoDavidW.Herd,david.herd@ Received9January2008;Accepted14May2008 RecommendedbyWalidA.Farhat Background.Voidingcystourethrogramsaredistressingforchildrenandparents.Nonpharmacologicalmethodsreducedistress. PharmacologicalinterventionsforVCUGfocusonsedationaswellasanalgesia,anxiolysis,andamnesia.Sedationhascost,time, andsafetyissues.Whichagentsandrouteshouldweuse?Arewesurethatsedationdoesnotin?uencetheabilitytodiagnose vesicouretericre?ux?Methods.LiteraturesearchofMedline,EMBASE,andtheCochraneDatabase.Reviewofcomparativestudies found.Results.Sevencomparativestudiesincludingtworandomisedcontrolledtrialswerereviewed.Midazolamgivenorally(0.5- 0.6mg/kg)orintranasally(0.2mg/kg)ise?ectivewithnoapparente?ectonvoidingdynamics.Insu?cientevidencetorecommend othersedatingagentswasfound.Deepersedatingagentsmayinterferewithvoidingdynamics.Conclusion.Midazolamreduces theVCUGdistress,causesamnesia,anddoesnotappeartointerferewithvoidingdynamics.Midazolamcombinedwithsimple analgesiaisane?ectivemethodtoreducedistresstochildrenundergoingVCUG. Copyright?2008DavidW.Herd.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense, whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited. 1. INTRODUCTION are important determinants of distress during a medical procedure [34]. Safety of sedating agents is excellent in the context of a sedation service with the necessary sta? andequipmenttomanagesedationinyoungchildren[35– 37]. Those who sedate children should be prepared for inadvertentdeepersedation,basiclifesupport,andairway management [29–31, 38–40]. Advanced help should be available.Timeandcostfactors