摘要
胃肠内镜检查不但可以通过内镜清楚地发现胃肠道病变,还可对部分病变进行治疗,但在患者清醒操作过程中的不适感往往会影响医师的操作。麻醉医师可以通过静脉给药为患者提供适度镇静、镇痛,提高患者舒适度,减少手术并发症。丙泊酚的应用在受到内镜医师和患者欢迎的同时,低血压、呼吸抑制等不良反应也不容忽视。所以,药物开发者和厂商都在努力寻找丙泊酚镇静的替代品。最新研究成果—瑞马唑仑,一种新型的苯二氮卓类药物,在代谢速度方面具有显著优势。此外,多药物联合应用的方案,如丙泊酚-右美托咪定和丙泊酚-氯胺酮联合,在不影响镇静效果前提下能够提高用药安全性。本文就目前胃肠内镜检查中新开发的镇静镇痛药物及其新的联合用药策略进行综述,为临床医师提供参考。
Gastrointestinal endoscopy can clearly detect gastrointestinal lesions through endoscopyas well as treating some gastrointestinal lesions.However,the patients always feel discomfort during the operation,which would affect the operation of the doctors.Anesthesiologists can provide the patients with moderate sedation and analgesia,relieve the patients’discomfort and thus reduce surgical associated complications by intravenous drug administration.While the application of Propofol is welcomed by endoscopy doctors and patients,the adverse reactions such as hypotension and respiratory depression should not be ignored.As a result,drug developers and manufacturers have been trying to find alternatives to Propofol sedation.The latest finding is Remimazolam,a new drug of benzodiazepines that exhibits promising superiority in faster metabolic rate.In addition,many protocols for drug combination applications,such as Propofol-Demetomidine and Propofol-Chloramine combination,can markedly improve drug safety without affecting sedation quality.In this paper,the newly developed sedative and analgesic drugs and new drug combination strategies to provide some references for the clinicians.
作者
史媛
董贝贝
于泳浩
SHI Yuan;DONG Beibei;YU Yonghao(Department of Anesthesiology,General Hospital of Tianjin Medical UniversityTianjin Institute of Anesthesiology,Tianjin300052,China)
出处
《中国医药导报》
CAS
2020年第34期64-67,共4页
China Medical Herald
基金
国家自然科学基金资助项目(81501013)。
关键词
胃肠内镜
镇静
丙泊酚
右美托咪定
瑞马唑仑
Gastrointestinal endoscopy
Sedation
Propofol
Dexmedetomidine
Remimazolam
