Haberer J P
Service d'Anesthésie-Réanimation Chirurgicale, Hôtel-Dieu, 1, place du Parvis Notre-Dame, 75004 Paris.
J Fr Ophtalmol. 2000 Nov;23(9):901-6.
Sedation allows patients to tolerate unpleasant procedures while maintaining adequate cardiorespiratory function and the ability to respond purposefully to verbal command. For ophthalmic surgery patient's anxiety and discomfort can be relieved during placement of a peribulbar block and during surgery by intravenous sedation. Intravenous sedation should only be administered by an anesthetist. Three different classes of drugs are used for intravenous sedation: analgesics (fentanyl and alfentanil), benzodiazepines (midazolam) and profofol, an intravenous anesthetic. Sedation may result in ventilatory, cardiovascular and neurologic complications. Excessive sedation can induce hypoventilation from central ventilatory depression or airway obstruction. Uncontrolled and unexpected movements of the head could result in major surgical complications. For the prevention of the complications related to sedation the same monitoring as for general anesthesia is essential.
镇静可使患者耐受不愉快的操作，同时维持足够的心肺功能以及对言语指令做出有目的反应的能力。对于眼科手术，在球周阻滞操作过程中以及手术期间，通过静脉镇静可缓解患者的焦虑和不适。静脉镇静仅应由麻醉师实施。用于静脉镇静的药物有三类：镇痛药（芬太尼和阿芬太尼）、苯二氮䓬类药物（咪达唑仑）以及静脉麻醉药丙泊酚。镇静可能导致通气、心血管和神经方面的并发症。过度镇静可因中枢性通气抑制或气道阻塞而诱发通气不足。头部不受控制的意外移动可能导致严重的手术并发症。为预防与镇静相关的并发症，与全身麻醉相同的监测至关重要。
