Vargo John J
Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Avenue Desk A30, Cleveland, OH 44195, USA.
Gastrointest Endosc Clin N Am. 2015 Jan;25(1):147-58. doi: 10.1016/j.giec.2014.09.009.
Defining the risk of procedural sedation for gastrointestinal endoscopic procedures remains a vexing challenge. The definitions as to what constitutes a cardiopulmonary unplanned event are beginning to take focus but the existing literature is an amalgam of various definitions and subjective outcomes, providing a challenge to patient, practitioner, and researcher. Gastrointestinal endoscopy when undertaken by trained personnel after the appropriate preprocedural evaluation and in the right setting is a safe experience. However, significant challenges exist in further quantifying the sedation risks to patients, optimizing physiologic monitoring, and sublimating the pharmacoeconomic and regulatory embroglios that limit the scope of practice and the quality of services delivered to patients.
确定胃肠内镜检查过程中实施程序性镇静的风险仍然是一项棘手的挑战。关于什么构成心肺意外事件的定义开始受到关注,但现有文献是各种定义和主观结果的混合体,给患者、从业者和研究人员带来了挑战。由经过培训的人员在进行适当的术前评估后并在合适的环境中进行胃肠内镜检查是一种安全的体验。然而,在进一步量化对患者的镇静风险、优化生理监测以及化解限制实践范围和提供给患者的服务质量的药物经济学和监管纠纷方面,存在重大挑战。