在患有耐药症状的患者中,在息镇静失败后,成功使用普罗波
Eduardo Garcia Romo1, Bernadette Pfang2, Beatriz Valle Borrego3
1Palliative Care Unit, Fundación Jiménez Díaz University Hospital, Madrid, Spain.
Journal of palliative medicine
|July 8, 2024
概括
这项研究表明,低剂量普罗波福尔方案有效地控制了息治疗患者的耐药症状,在没有呼吸系统不良事件的情况下实现了深度镇静. 这促进了用于终身症状控制的普罗波的使用.
科学领域:
- 抚慰性护理是一种缓解性护理.
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
背景情况:
- 普罗波福 (propofol) 是一种全身麻醉剂,尽管有证据支持其使用,但它在息镇静中未得到充分利用.
- 害怕不良事件,特别是呼吸停止,有助于不愿意采用息镇静剂的propofol.
- 耐药症状和复杂的镇静需要在终身护理中提出挑战.
研究的目的:
- 为了评估低剂量,渐进式的普罗波福尔剂量方案的疗效和安全性,用于缓解性镇静.
- 评估普罗波福尔在治疗复杂镇静需求的患者中耐火症状的有效性.
- 为了确定不良事件的发生率,特别是呼吸抑制和呼吸暂停,在普罗波福尔诱导的息镇静期间.
主要方法:
- 在马德里一家息治疗病房的22名住院患者进行了回顾性观察性研究 (2018年3月 - 2023年2月).
- 利用一种新开发的,使用低剂量增量剂量的息性镇静的协议,使用普罗波福.
- 患者此前已经失败了其他镇静药物,并呈现了复杂镇静的风险因素.
主要成果:
- 在所有22名患者中,普罗波成功控制了耐火性症状,主要是精神存在性痛苦和妄想.
- 达到了深度镇静水平 (兰赛镇静量表),总剂量有显著的变化.
- 在诱导过程中没有记录过呼吸暂停或死亡的病例; 77%的患者接受了综合疗法以获得协同效应.
结论:
- 一个低剂量,增量型的propofol协议,随着可选的诱导玻尿酸,证明了息镇静的有效性和安全性.
- 该方案有效地实现了足够的镇静水平,而不会导致呼吸暂停或呼吸抑制.
- 这些发现支持扩大在耐药症状和高风险临终期患者中用于息镇静的普罗波的使用.
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