快速序列输管,是时候找一个替代的诱导剂吗? 一个叙事审查
Brett A Faine1, Elisabeth Carroll2, Archit Sharma3
1Department of Emergency Medicine and Pharmacy, University of Iowa, Iowa City, IA, USA.
Journal of pharmacy practice
|August 18, 2023
概括
芬太尼与镇静剂为重症患者提供了良好的输管条件,血液动力学变化最小. 需要进一步的研究来确认其作为快速序列输管 (RSI) 的唯一诱导剂的安全性.
科学领域:
- 关键护理医学 关键护理医学
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
背景情况:
- 目前用于急症患者的快速序列输管 (RSI) 的诱导药物,如埃托米达和胺,具有不良事件的风险.
- 芬太尼是一种强烈的阿片类药物,由于其有利的血液动力学特征和快速发作,它是一个潜在的替代品.
研究的目的:
- 审查芬太尼作为RSI诱导剂在重症患者中的疗效,安全性和治疗作用.
- 综合现有的关于芬太尼在手术室 (OR) 和非OR环境中的使用数据.
主要方法:
- 在PubMed,EMBASE和临床试验注册表中进行了全面的文献搜索 (1964年至2021年6月).
- 包括评估芬太尼作为输管唯一或辅助诱导剂的初级文献.
- 分析重点是同行评审的出版物和积极招募临床试验.
主要成果:
- 芬太尼在手术室中作为辅助剂和唯一诱导剂的使用历史悠久.
- 当与镇静剂相结合时,芬太尼可促进最佳的输管条件与最小的血液动力学影响.
- 关于芬太尼在重症患者中作为唯一诱导剂的最佳剂量和安全性的数据有限,非OR患者.
结论:
- 当与镇静剂一起使用时,芬太尼在重症患者的RSI中有效,保持血液动力学稳定性.
- 需要进一步研究麻期间的安全性和意识潜力,才能建议芬太尼作为RSI的唯一诱导剂.
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