静脉麻醉在无痛内镜诊疗中应用的研究进展  

Research progress of intravenous anesthesia in painless endoscopic diagnosis and treatment

作　　者：白清海 张强 梁亮亮 陈道恩 BAI Qinghai;ZHANG Qiang;LIANG Liangliang;CHEN Daoen(Department of Anesthesiology of People's Hospital of Xifeng District,Qingyang 745000,China)

机构地区：[1]庆阳市西峰区人民医院麻醉科,甘肃庆阳745000

出　　处：《麻醉安全与质控》2024年第5期295-299,共5页Perioperative Safety and Quality Assurance

摘　　要：随着社会经济、现代医学及医学装备的发展,国民的健康意识水平越来越高,加之国家对重大疾病筛查项目的实施,各种内镜检查和治疗的患者越来越多,对精准化、舒适化医疗的需求日益增多,各种无痛内镜诊疗也应运而生。胃肠镜、支气管镜、膀胱镜、宫腔镜等内镜诊疗都是侵入性操作,检查操作易引起患者强烈不适,还可出现低氧血症、心律失常等并发症,影响检查质量和患者安全。内镜医生采用表面麻醉、局部雾化麻醉、局部浸润麻醉等都未达到满意效果,建议为患者提供适度的镇静、镇痛,以提高患者的舒适度,减少并发症发生并实现精准化诊疗。内镜诊疗常用的静脉药物包括镇静药物、镇痛药物、抗胆碱类药物、血管活性药物及止吐类药物等,镇静、镇痛药物可以组合使用。根据不同的患者、不同的内镜诊疗,如何制定个体化麻醉方案是每一个麻醉医生面临的挑战,既要确保患者安全、舒适,又要实现药物对患者的影响最小、患者满意度高。本文旨在总结评价应用于无痛内镜诊疗的麻醉及其相关药物,以期为临床提供指导并推广使用。With the rapid development of social economy,modern medicine and medical equipment,the level of national health awareness is increasing.Coupled with the implementation of national screening programs for major diseases,there is a growing number of patients undergoing various endoscopic examinations and treatments,leading to an increasing demand for precise and comfortable medical care.Various painless endoscopic diagnosis and treatment have emerged accordingly.Gastrointestinal endoscopy,bronchoscopy,cystoscopy,hysteroscopy,and other endoscopic diagnoses and treatments are invasive procedures,which can easily cause strong discomfort to patients and may lead to complications such as hypoxemia and arrhythmia,affecting the quality of examination and patient safety.The use of surface anesthesia,local nebulized anesthesia,and local infiltration anesthesia by endoscopists has not achieved satisfactory results.It is recommended to provide moderate sedation and analgesia for patients to enhance their comfort,reduce the occurrence of complications,and achieve precise diagnosis and treatment.Common intravenous drugs used in endoscopic diagnosis and treatment include sedatives,analgesics,anticholinergics,vasoactive drugs,and antiemetic drugs,among which sedatives and analgesics can be used in combination.Formulating individualized anesthesia plans for different patients and different endoscopic diagnoses and treatments is a challenge faced by every anesthesiologist,who must ensure patients'safety and comfort while minimizing the impact of drugs on patients and achieving high patients'satisfaction.This review aims to summarize and evaluate related drugs used in painless endoscopic diagnosis and treatment,providing guidance for clinical practice.

关 键 词：静脉麻醉 内镜诊疗 镇静药 镇痛药 

分 类 号：R614[医药卫生—麻醉学]