Lubarsky David A, Candiotti Keith, Harris Eric
Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL 33136, USA.
J Clin Anesth. 2007 Aug;19(5):397-404. doi: 10.1016/j.jclinane.2006.11.006.
Recommendations for routine screening for colorectal cancer with colonoscopy are likely to substantially increase the demand for provision of sedation for these procedures. Because of this burgeoning caseload and associated economic constraints, it is unlikely that anesthesiologists will be available for all such procedures, particularly those involving average-risk patients. Thus, sedative agents that can be safely administered by nonanesthesiologists, appropriately trained in monitoring and managing the patient's airway, are desperately needed. New concepts in sedation for colonoscopy include enhanced mechanisms for drug delivery such as patient-controlled sedation/analgesia and target-controlled infusion, along with the development of new drugs such as a modified cyclodextrin-based formulation of propofol and fospropofol disodium (Aquavan Injection), a water-soluble prodrug of propofol.
采用结肠镜检查对结直肠癌进行常规筛查的建议可能会大幅增加这些检查中镇静服务的需求。由于此类病例数量迅速增加以及相关经济限制，麻醉医生不太可能参与所有此类检查，尤其是那些涉及平均风险患者的检查。因此，迫切需要能够由经过适当培训以监测和管理患者气道的非麻醉医生安全给药的镇静剂。结肠镜检查镇静的新概念包括增强药物递送机制，如患者自控镇静/镇痛和靶控输注，以及开发新药物，如基于改良环糊精的丙泊酚制剂和丙泊酚二钠（水乐维他注射液），丙泊酚的一种水溶性前体药物。
