药物诱导睡眠内镜 (DISE) 镇静技术的有争议的方面-一个叙述性审查
Narcis-Valentin Tănase1,2, Catalina Voiosu3,4, Luana-Maria Gherasie3,4
1Department of Anaesthesia and Intensive Care Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Medical sciences (Basel, Switzerland)
|February 20, 2026
概括
在阻塞性睡眠呼吸暂停 (OSA) 中,药物诱导睡眠内镜 (DISE) 的最佳镇静需要平衡深度和安全性. 使用最低有效剂量,以监测为指导,是关键,但需要标准化的协议.
科学领域:
- 睡眠医学 睡眠医学
- 麻醉学 麻醉学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
背景情况:
- 药物诱导睡眠内镜 (DISE) 是通过可视化呼吸道崩来诊断阻塞性睡眠呼吸暂停 (OSA) 的关键.
- 目前对DISE的镇静方案缺乏标准化,导致不同的临床结果.
- 最佳镇静对于准确评估气道动力学而不是诱导人工崩至关重要.
研究的目的:
- 审查和澄清目前在OSA患者中对DISE的镇静策略.
- 讨论不同镇静剂和技术的临床影响.
- 确定未来研究和协议开发的领域.
主要方法:
- 从2000年到2025年,对主要数据库 (PubMed,Scopus,科学网,柯克伦图书馆) 的系统文献搜索.
- 包括关于DISE镇静的临床研究,指导方针和评论.
- 由于研究异质性,对数据进行定性综合.
主要成果:
- 普罗波福,德克斯梅德托米丁和米达佐拉姆是常见的药物,每个药物对镇静和呼吸道折叠性都有不同的影响.
- 与普罗波或米达佐拉姆相比,德克斯梅德托米丁提供了一个自然的睡眠状态,呼吸抑制较少.
- 目标控制输注和PK-PD建模增强了普罗波福的镇静控制;辅助镇静剂增加了风险.
- 最低有效剂量定位,通常与双光谱指数 (BIS) 监测一起,建议避免人工崩.
结论:
- 为了达到最佳的DISE镇静,需要平衡镇静深度与患者安全,以获得可靠的诊断结果.
- 最小化镇静剂量和利用像BIS这样的客观监测是推的做法.
- 标准化方案和进一步的研究,特别是在肥胖的OSA患者中,是必要的,以提高DISE的实用性.
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