Park Hong Jun, Kim Byung-Wook, Lee Jun Kyu, Park Yehyun, Park Jin Myung, Bae Jun Yong, Seo Seung Young, Lee Jae Min, Lee Jee Hyun, Chon Hyung Ku, Chung Jun-Won, Choi Hyun Ho, Kim Myung Ha, Park Dong Ah, Jung Jae Hung, Cho Joo Young
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Korean J Gastroenterol. 2022 Apr 25;79(4):141-155. doi: 10.4166/kjg.2021.157.
Sedation can resolve anxiety and fear in patients undergoing endoscopy. The use of sedatives has increased in Korea. Appropriate sedation is a state in which the patient feels subjectively comfortable while maintaining the airway reflex for stable spontaneous breathing. The patient should maintain a state of consciousness to the extent that he or she can cooperate with the needs of the medical staff. Despite its benefits, endoscopic sedation has been associated with cardiopulmonary complications. Cardiopulmonary complications are usually temporary. Most patients recover without sequelae. However, they may progress to serious complications, such as cardiovascular collapse. Therefore, it is essential to screen high-risk patients before sedation and reduce complications by meticulous monitoring. Additionally, physicians should be familiar with the management of emergencies. The first Korean clinical practice guideline for endoscopic sedation was developed based on previous worldwide guidelines for endoscopic sedation using an adaptation process. The guideline consists of nine recommendations based on a critical review of currently available data and expert consensus when the guideline was drafted. These guidelines should provide clinicians, nurses, medical school students, and policy makers with information on how to perform endoscopic sedation with minimal risk.
镇静可缓解接受内镜检查患者的焦虑和恐惧。韩国镇静剂的使用有所增加。适当的镇静是指患者主观感觉舒适，同时保持气道反射以维持稳定的自主呼吸。患者应保持一定程度的意识状态，以便能够配合医护人员的需求。尽管内镜镇静有诸多益处，但它与心肺并发症有关。心肺并发症通常是暂时的。大多数患者恢复后无后遗症。然而，它们可能进展为严重并发症，如心血管衰竭。因此，在镇静前筛查高危患者并通过细致监测减少并发症至关重要。此外，医生应熟悉紧急情况的处理。韩国首个内镜镇静临床实践指南是在借鉴以往全球内镜镇静指南的基础上，通过改编过程制定的。该指南基于对当前可用数据的批判性审查以及起草指南时的专家共识提出了九条建议。这些指南应向临床医生、护士、医学生和政策制定者提供有关如何以最小风险进行内镜镇静的信息。
