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患者对支气管镜检查清醒镇静的满意度。

Patient satisfaction with conscious sedation for bronchoscopy.

作者信息

Putinati S, Ballerin L, Corbetta L, Trevisani L, Potena A

机构信息

Divisione di Fisiopatologia Respiratoria, Arcispedale S. Anna, Ferrara, Italy.

出版信息

Chest. 1999 May;115(5):1437-40. doi: 10.1378/chest.115.5.1437.

Abstract

STUDY OBJECTIVE

Bronchoscopic technique is not standardized. Controversies exist with regard to premedication with sedatives before the test. To evaluate safety and efficacy of conscious sedation, we studied 100 randomized patients undergoing diagnostic bronchoscopy; patients received premedication with lidocaine spray and atropine sulfate i.m. (nonsedation group; 50 patients) or lidocaine spray, atropine i.m. and diazepam i.v. (sedation group; 50 patients).

METHODS AND RESULTS

Monitoring during flexible fiberoptic bronchoscopy included continuous ECG and pulse oximetry. The procedure could not be completed in six patients. None received premedication with diazepam; among the patients who ended the examination, tolerance to the examination (visual analogue scale, 0 to 100; 0 = excellent; 100 = unbearable) was better in the sedation group. Low anxiety, male sex, but not age were also associated with improved patient tolerance to the test. Oxygen desaturation occurred in 17% of patients, and it was not more frequent after diazepam treatment.

CONCLUSIONS

In our study, sedation had a beneficial effect on patient tolerance and rarely induced significant alterations in cardiorespiratory monitoring parameters.

摘要

研究目的

支气管镜检查技术未标准化。关于检查前使用镇静剂进行预处理存在争议。为评估清醒镇静的安全性和有效性,我们对100例接受诊断性支气管镜检查的随机患者进行了研究;患者接受利多卡因喷雾和硫酸阿托品肌肉注射预处理(非镇静组;50例患者)或利多卡因喷雾、阿托品肌肉注射和地西泮静脉注射(镇静组;50例患者)。

方法与结果

在纤维支气管镜检查期间的监测包括连续心电图和脉搏血氧饱和度监测。6例患者未能完成该检查。均未接受地西泮预处理;在完成检查的患者中,镇静组对检查的耐受性(视觉模拟评分,0至100;0=极佳;100=无法忍受)更好。低焦虑、男性,但年龄并非与患者对检查的耐受性改善相关。17%的患者出现氧饱和度下降,地西泮治疗后并未更频繁出现。

结论

在我们的研究中,镇静对患者耐受性有有益影响,且很少引起心肺监测参数的显著改变。

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