在动态支气管镜检查中缓解呼吸中心气道崩时的镇静:什么是理想的方案?
Rodrigo Funes-Ferrada1, Alejandra Yu Lee-Mateus1, Bryan F Vaca-Cartagena1
1Division of Pulmonary, Allergy and Sleep Medicine, Mayo Clinic, Jacksonville, FL, USA.
Respiratory medicine
|December 5, 2024
概括
与单独使用雷米马佐拉姆相比,用于动态支气管透视 (DB) 的雷米马佐拉姆/芬太尼尔镇静改善了呼吸道崩评估质量. 该方案显示了与普罗波相似的结果,但没有增加麻醉后护理单位的停留时间.
科学领域:
- 肺部病理学 肺部病理学
- 麻醉学 麻醉学
背景情况:
- 动态支气管镜检查 (DB) 对于诊断出口中心气道崩 (ECAC) 非常重要.
- 优化镇静方案对于有效的DB和准确的ECAC评估至关重要.
研究的目的:
- 为了比较动态支气管检查的不同镇静方案的疗效,评估呼气中枢气道崩.
- 确定最佳的镇静策略,以提高DB期间的诊断质量.
主要方法:
- 一项观察性研究涉及成年患者怀疑ECAC接受DB.
- 患者被分为三个镇静剂组:普罗波福,雷米马佐拉姆和雷米马佐拉姆/芬太尼.
- 评估质量以利克尔特级别进行评分;二级结果包括麻醉持续时间和PACU停留时间.
主要成果:
- 与单独使用雷米马佐拉姆相比,雷米马佐拉姆/芬太尼协议 (协议3) 显示出明显更好的DB评估质量 (协议2).
- 第3条例显示,评估质量与普罗波 (第1条例) 的评估质量相当.
- 在协议之间没有观察到麻醉后护理单位 (PACU) 停留时间的显著差异.
结论:
- 雷米马佐拉姆/芬太尼镇静方案对DB有效,提高了ECAC的评估质量.
- 该方案提供了一个可行的替代品,不影响患者的康复时间.
- 需要进一步的前性研究来验证这些发现.
相关概念视频
Endotracheal Tube Extubation
399
Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
399
Stages of General Anesthesia
369
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
369
Endotracheal Intubation I: Procedure
741
Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
741
Endoscopic Studies II: Thoracocentesis
199
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
199
Inhalational Anesthetics: Overview
192
Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
192
Skeletal Muscle Relaxants: Therapeutic Uses
463
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
463


