在内镜手术中进行由患者控制的普罗波 - 雷米芬坦尼尔镇静:未来服务审计
Paula J Joy1, Hannah J Blanshard2,3
1School of Anaesthesia, Severn Deanery, Bristol, UK.
Canadian journal of anaesthesia = Journal canadien d'anesthesie
|October 9, 2023
概括
用于内镜检查的患者控制的propofol-remifentanil镇静是安全有效的. 这项服务确保了足够的镇静和高患者满意度,并发症率低.
科学领域:
- 麻醉学 麻醉学
- 胃肠病学 胃肠病学
- 患者安全 患者安全
背景情况:
- 需要在内镜手术中改进镇静选择.
- 传统内镜医生给药镇静的局限性.
- 需要麻醉师监督的患者控制的镇静服务.
研究的目的:
- 评估一种新的患者控制的,用于内镜的propofol-remifentanil镇静服务的有效性和安全性.
- 为了评估镇静的充分性和患者的满意度.
- 为了识别和分类不良事件.
主要方法:
- 对670个内镜手术 (2017-2021) 的前性审计.
- 使用了普罗波福-雷米芬坦尼尔混合物,并以患者控制的剂量 (1-mL玻尿酸,20秒锁定).
- 通过修改格洛斯特尺度评估镇静剂的充分性;不良事件使用TRACE进行分类.
主要成果:
- 所有670项手术都实现了充分的镇静,无需通风或全身麻醉 (GA).
- 患者满意度普遍;并发症率低 (2.8%的呼吸道阻塞,1%的呼吸暂停,0.4%的吐).
- 没有发生吸血事件;2.6%需要血管压缩剂来控制血压.
结论:
- 患者控制的propofol-remifentanil镇静是一种安全有效的内镜手术技术.
- 该服务显示了高的患者满意度和最小的不良事件.
- 该模型为需要高级镇静的患者提供了可靠的替代方案.
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