intravenousanaesthesia：靜脈麻醉-資料下載頁
2025-01-12 08:18本頁面
【正文】 Arteriovenous fistula 26 7 8 Dilatation amp。 Curettage 56 24 Lithotripsy 32 8 12 Ureteroscopy 26 4 14 Transesophageal echocardiogram 105 26 Bunionectomy 31 3 12 Hysteroscopy 26 12 Arthroscopy 25 2 4 Esophagogastroduodenoscopy Max Min Median Procedure Adverse Events ? Majority of adverse events (AEs) were mild to moderate ? Serious AEs (n = 4) – n=2 atrial septal defect, n=1 apnea and cardiac arrest, n=1 increased ammonia and hepatic encephalopathy ? Treatmentrelated AEs – Most mon were perineal paresthesias (%) and pruritus (%) ? Sedationrelated AEs (5 patients, %) – Hypoxemia (n=1, 1min and managed with verbal stimulation and chin lift) – Hypotension (n=4, occurred during the dosing and recovery periods) – Bradycardia (n=1 concurrently with hypotension and managed with atropine) ? No deaths reported and no procedure discontinued due to adverse event Hepatic and Renal Impairment MSURG523 ?20/123 (16%) patients had previous or existing hepatic disease (minimal – severe) ?5/123 (4%) patients had severe renal impairment (creatinine clearance 1136 mL/min) ?Adverse event rates were similar to overall population – Treatmentrelated AEs were similar to other patients (paresthesia 50%, pruritus 30%) ?No sedationrelated adverse events reported For general anesthesia or monitored anesthesia care (MAC) sedation, DIPRIVAN Injectable Emulsion should be administered only by persons trained in the administration of general anesthesia and not involved in the conduct of the surgical/diagnostic procedure.” Package Insert for Fospropofol Similar to Propofol Future Better pharmacological agents – Better sedatives and analgesics Better delivery system – Patientcontrolled sedation Better monitoring system – Closedloop control Conclusions I Sedation ensures that patients are fortable when undergoing minor medical and surgical procedures Constant monitoring of patients during sedation ensures safety and a good oute Practitioners caring for patients under sedation should be properly educated on the pharmacology of the drugs used during sedation as well as how to bine hypnotics and analgesics Conclusions II Minimum and moderate sedation can be safely performed by sedation nurses under the supervision of the physician Deep sedation should be cared for by medical personnel with the appropriate training and appropriate monitoring technology Propofol and fospropfol are efficacious and safe when administered by medical personnel with the appropriate training and appropriate monitoring technology. Conclusions III Even if moderate sedation is intended, patients receiving propofol or fospropofol should receive care consistent with that required for deep sedation. This means that the clinician administering propofol or fospropofol must be petent to recognize a state of general anesthesia and rescue a patient experiencing any of the plications of general anesthesia.
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