Moos Daniel D
Kearney Anesthesia Associates, Kearney, Nebraska 68847, USA.
Gastroenterol Nurs. 2006 Nov-Dec;29(6):456-63; quiz 464-5. doi: 10.1097/00001610-200611000-00004.
Patients with obstructive sleep apnea are at risk of mortality and morbidity related to the administration of sedatives, anesthetics, and opioids. Commonly employed sedatives and analgesics promote pharyngeal collapse and alter normal respiratory responses to obstruction and apnea. Literature concerning patients with obstructive sleep apnea undergoing moderate and deep sedation in the endoscopy suite is lacking. The purpose of this article is to provide the reader with a review of normal airway patency, the effects of obstructive sleep apnea on airway patency, and the impact that analgesics and sedatives may impart on the airway of patients with obstructive sleep apnea. The goal of this article is to increase awareness, stimulate discussions within the gastroenterological community, and encourage research regarding sedation in this at-risk population.
阻塞性睡眠呼吸暂停患者在使用镇静剂、麻醉剂和阿片类药物时存在死亡和发病风险。常用的镇静剂和镇痛药会促进咽部塌陷,并改变对阻塞和呼吸暂停的正常呼吸反应。目前缺乏关于在内镜检查室中接受中度和深度镇静的阻塞性睡眠呼吸暂停患者的文献。本文旨在向读者综述正常气道通畅情况、阻塞性睡眠呼吸暂停对气道通畅的影响,以及镇痛药和镇静剂可能对阻塞性睡眠呼吸暂停患者气道产生的影响。本文的目的是提高认识、激发胃肠病学界的讨论,并鼓励针对这一高危人群的镇静研究。