评估儿科住院人员的程序镇静培训计划:可行性,质量和并发症率
Michal Vinker-Shuster1,2, Uriel Ezra1, Noy Cohen-Ronen2,3
1Department of Pediatrics, Assuta Ashdod University Medical Center, Ashdod.
Pediatric emergency care
|July 3, 2025
概括
儿科住院医生可以安全地进行手术镇静 (PS),成功率高,并发症率低. 儿科住院医生的培训计划提高了儿科护理中PS的质量和安全性.
科学领域:
- 儿科急救医学 儿科急救医学
- 镇静和止痛药的使用
- 医学教育 医学教育
背景情况:
- 程序性镇静 (PS) 在儿科护理中至关重要,通常由住院医生进行.
- 越来越多的需求需要有效和安全的PS实践.
- 评估居民培训计划对于提高质量至关重要.
研究的目的:
- 评估儿科住院医生手术镇静培训计划的质量和并发症率.
- 为了确定儿科住院医生进行的PS的安全性和有效性.
- 分析影响儿科PS期间不良事件的因素.
主要方法:
- 从2017年11月到2021年7月,对3156名儿科PS (1-18岁) 的回顾性分析.
- 收集关于镇静的原因,过程,药物和并发症的数据.
- 主要并发症定义为需要正压通风,喉发作,心肺复苏或意外入院.
主要成果:
- 所有镇静剂都成功;98.4%没有任何不良事件.
- 轻度不良事件发生在1.6%的病例中 (例如,呼吸道重新定位,轻度缺氧).
- 较高的轻度不良事件的几率与慢性疾病和仅仅居民的PS相关 (OR=2.26).
结论:
- 由训练有素的儿科住院医生领导的程序性镇静服务是可行的.
- 较高的成功率和较低的不良反应发生率证实了该计划的有效性.
- 居民主导的PS有助于提供具有可接受安全概况的优质儿科护理.
相关概念视频
Parenteral Anesthetics: Overview
203
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
203
Stages of General Anesthesia
729
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...
729
Sedatives and Hypnotics: Overview
670
Sedatives are drugs that alleviate anxiety, while hypnotics induce sleep. Both classes of medication suppress neuronal activity, leading to a calming effect for sedatives and facilitating sleep for hypnotics.
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
670
Inhalational Anesthetics: Overview
534
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...
534
General Anesthesia: Overview
289
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
289
Local Anesthetics: Clinical Application as Epidural Anesthesia
502
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
502


