Becker K
Z Gastroenterol. 1977 Jun;15(6):356-61.
In these introductory remarks the application of sedatives in patients with chronic liver diseases is discussed. Sedatives, for example, are used in agitated alcoholics with liver damage, as premedication before endoscopical examinations (emergency endoscopy for hemorrhage from the upper G.i.-tract, peritoneoscopy), and operations necessary for the treatment of typical complications of the liver disease (shunt-op. for portal hypertension). In all these situations the metabolism and pharmaco-kinetics of sedatives may be influenced by the liver disease in a non-predictable way. Generally, an enhanced, enforced and prolonged effect can be assumed. Long acting barbiturates are recommended for a long period treatment, diazepam in reduced doses is used as premedication for endoscopical examination. Opiates should be avoided.
在这些引言性评论中，讨论了镇静剂在慢性肝病患者中的应用。例如，镇静剂用于患有肝损伤的躁动酗酒者，作为内镜检查（上消化道出血的急诊内镜检查、腹腔镜检查）以及治疗肝病典型并发症所需手术（门静脉高压分流术）前的术前用药。在所有这些情况下，肝病可能以不可预测的方式影响镇静剂的代谢和药代动力学。一般来说，可以假定会有增强、强化和延长的效果。长效巴比妥类药物推荐用于长期治疗，小剂量地西泮用作内镜检查的术前用药。应避免使用阿片类药物。
