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在印度南部,日间门诊纤维支气管镜检查中使用雾化右美托咪定进行清醒镇静的临床效果。

Clinical usefulness of nebulized dexmedetomidine for conscious sedation in daycare flexible bronchoscopy in Southern India.

机构信息

Department of Pulmonary Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.

出版信息

Indian J Pharmacol. 2024 Mar 1;56(2):105-111. doi: 10.4103/ijp.ijp_160_23. Epub 2024 Apr 30.

Abstract

BACKGROUND

Sedative agents used in bronchoscopy require trained personnel to administer and monitor the patient. This increases the procedure cost, duration, and inpatient stay. Inhalational administration of sedative agents can be a practical solution to the issue. Dexmedetomidine in the inhalational form could give results similar to the intravenous form without significant adverse events.

MATERIALS AND METHODS

The study is prospective, randomized, and double-blinded study. Patients needing bronchoscopy were randomized to receive the nebulized form of either dexmedetomidine or saline (0.9%) before bronchoscopy. The study parameters are assessed and recorded before, during, and after bronchoscopy. Data collected are analyzed using the SPSS software.

DISCUSSION

The side effects limit using commonly administered sedation agents in bronchoscopy, such as midazolam, fentanyl, and dexmedetomidine. The nebulized dexmedetomidine is safe with proven efficacy when compared to the placebo. Proceduralist-administered conscious sedation reduces the overall cost and shortens inpatient stays. Attenuation of hemodynamic parameters by dexmedetomidine could be an advantage for the physician in reducing an untoward cardiac event.

CONCLUSION

Dexmedetomidine in the nebulized form improves the comfort of patients during the procedure. It blunts the pressure response during bronchoscopy and could be a safer and cost-effective agent in its nebulized form for conscious sedation in bronchoscopy. The study is approved by the institutional ethics committee (IEC KMC MLR 10-2021-310).

摘要

背景

支气管镜检查中使用的镇静剂需要经过培训的人员来给药和监测患者。这增加了手术成本、时间和住院时间。吸入性镇静剂的给药方式可能是解决这一问题的实用方法。吸入形式的右美托咪定可以达到与静脉形式相似的效果,而没有明显的不良事件。

材料和方法

该研究是前瞻性、随机和双盲研究。需要支气管镜检查的患者被随机分为在支气管镜检查前接受右美托咪定或生理盐水(0.9%)的雾化形式。在支气管镜检查前后评估和记录研究参数。使用 SPSS 软件分析收集的数据。

讨论

副作用限制了在支气管镜检查中常用的镇静剂的使用,如咪达唑仑、芬太尼和右美托咪定。与安慰剂相比,雾化右美托咪定具有安全性和有效性。程序操作者给予的清醒镇静可降低整体成本并缩短住院时间。右美托咪定对血流动力学参数的衰减可能是医生减少不良心脏事件的优势。

结论

雾化右美托咪定可改善患者在手术过程中的舒适度。它可减轻支气管镜检查期间的压力反应,并且在其雾化形式下作为清醒镇静剂可能是一种更安全、更具成本效益的药物。该研究已获得机构伦理委员会的批准(IEC KMC MLR 10-2021-310)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9313/11161002/16091be2f921/IJPharm-56-105-g001.jpg

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