Song Jong Wook, Soh Sarah, Shim Jae Kwang
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
Korean Circ J. 2020 Jan;50(1):1-11. doi: 10.4070/kcj.2019.0269. Epub 2019 Sep 16.
The interventional cardiology is growing and evolving. Many complex procedures are now performed outside the operating room to manage cardiovascular pathologies which had been traditionally treated with cardiac surgery. Appropriate sedation strategy is crucial for improved patient comfort and successful procedure while ensuring safety. Sedation for cardiovascular intervention is frequently challenging, especially in critically-ill, high-risk patients. This review addresses pre-procedure evaluation and preparation of patients, proper monitoring, commonly used sedatives and analgesics, and considerations for specific procedures. Appropriate depth of sedation and analgesia should be balanced with patient, procedural and institutional factors. Understanding of the pharmacology of sedatives/analgesics, vigilant monitoring, ability and proper preparation for management of potential complications may improve outcomes in patients undergoing sedation for cardiovascular procedures.
介入心脏病学正在不断发展。如今,许多复杂手术在手术室之外进行,以处理传统上通过心脏手术治疗的心血管疾病。适当的镇静策略对于提高患者舒适度和确保手术成功同时保证安全至关重要。心血管介入手术的镇静常常具有挑战性,尤其是在危重症、高危患者中。本文综述了患者的术前评估与准备、适当的监测、常用的镇静剂和镇痛药,以及特定手术的注意事项。适当的镇静和镇痛深度应与患者、手术和机构因素相平衡。了解镇静剂/镇痛药的药理学、进行警惕的监测、具备处理潜在并发症的能力和适当准备,可能会改善接受心血管手术镇静患者的预后。