在灵活的干预性支气管镜和EBUS期间,支气管镜医生指导的基于Propofol的连续流动疼痛静坐
Georg Evers1, Michael Mohr1, Lena Sprakel1
1Department of Medicine A, Hematology, Oncology and Pulmonary Medicine, University Hospital Münster, 48149 Münster, Germany.
Journal of clinical medicine
|July 14, 2023
概括
使用普罗波福和佩提丁 (BDcfP) 进行深度疼痛静止治疗对于干预性支气管镜检查和EBUS-TBNA来说是安全的,即使工作人员有限. 这种方法为全身麻醉提供了一个可行的替代方案.
科学领域:
- 肺部病理学 肺部病理学
- 麻醉学 麻醉学
- 干预性肺病学 干预性肺病学
背景情况:
- 干预性灵活支气管镜检查和内支气管内超声导向跨支气管针吸收 (EBUS-TBNA) 的镇静技术缺乏标准化.
- 支持全身麻醉的证据对于完全麻醉学参与的这些程序是有限的.
- 在人数减少的情况下提供支气管镜护理是一个重大挑战.
研究的目的:
- 评估深度分析方法的安全性和可行性.
- 在两人设置中评估支气管镜师指导的基于普罗波的连续流动疼痛静止治疗 (BDcfP).
- 在这些手术过程中识别周围手术低血压的危险因素.
主要方法:
- 在2020年1月至2022年8月期间,对513名接受灵活干预支气管镜和/或EBUS-TBNA的患者进行了回顾性分析.
- 实施BDcfP,使用pethidine/meperidine玻尿酸加上连续流调整的propofol.
- 监测周围手术低血压,并确定相关的危险因素.
主要成果:
- 在513名患者中,有502名患者接受了BDcfP用于疼痛镇静.
- 心血管并发症,慢性肺炎和动脉高血压被确定为周围手术性低血压的危险因素.
- 普罗波的流速与低血压无关;提奥德里纳林,咖啡丁和米达佐拉姆被认为是潜在的治疗/辅助剂.
结论:
- 支气管镜医生指导的基于普罗波的连续流止痛疗法 (BDcfP) 是干预性灵活支气管镜术和EBUS-TBNA的安全和可行的镇静策略.
- 这种方法使得EBUS-TBNA和干预性柔性支气管检查可以在安全措施实施后,即使在有限的人员的情况下,也可以安全地进行.
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