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对接受胃肠内镜检查患者实施镇静的指南的批判性分析

Critical Analysis of Guidelines for Providing Sedation to Patients Undergoing Gastrointestinal Endoscopy Procedures.

作者信息

Goudra Basavana, Singh Preet Mohinder

机构信息

Department of Anesthesiology and Critical Care Medicine, Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.

Department of Anesthesiology, Washington University in Saint Louis, St. Louis, Missouri, USA.

出版信息

Anesth Essays Res. 2019 Oct-Dec;13(4):601-607. doi: 10.4103/aer.AER_135_19. Epub 2019 Dec 16.

Abstract

In spite of growing numbers of gastrointestinal endoscopic procedures performed under deep sedation, guidelines are lacking. Hypoxemia and aspiration continue to be the main source of morbidity. Anesthesia providers have tried to address these concerns by modifying their technique and employing newer or improvised devices. In addition, preprocedural evaluation poses many challenges. In many centers, workload pressures determine the time available to perform such an evaluation. A comprehensive history and examination similar to a major surgical procedure is often not possible. As a result, a focused history and examination is essential. This should be followed by an appropriate explanation of risks before obtaining consent. A plan should be in place to manage complications such as aspiration. This paper provides a succinct review of the above aspects.

摘要

尽管在深度镇静下进行的胃肠道内镜检查手术数量不断增加,但相关指南却很缺乏。低氧血症和误吸仍然是发病的主要原因。麻醉医护人员试图通过改进技术和使用更新的或临时制作的设备来解决这些问题。此外,术前评估也带来了许多挑战。在许多中心,工作量压力决定了可用于进行此类评估的时间。通常无法像进行大型外科手术那样进行全面的病史采集和检查。因此,重点突出的病史采集和检查至关重要。在获得同意之前,应随后对风险进行适当解释。应该制定一个计划来处理诸如误吸等并发症。本文对上述方面进行了简要综述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/863a/6937897/68b4ad506853/AER-13-601-g001.jpg

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