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題名 | 加護病房侵入性技術之鎮靜止痛=Sedation and Analgesia for Invasive Procedures in Intensive Care Unit |
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作者 | 陳穎心; 趙怡芬; 王鎮華; 劉治民; 葉育彰; Chan, Wing-sum; Chao, I-fang; Wang, Chen-hua; Liu, Chi-min; Yeh, Yu Chang; |
期刊 | 中華民國重症醫學雜誌 |
出版日期 | 20060000 |
卷期 | 8:2 民95 |
頁次 | 頁59-70 |
分類號 | 416.5 |
語文 | chi |
關鍵詞 | 重症加護; 侵入性技術; 鎮靜; 止痛; 併發症; 醫療品質; Critical care; Invasive procedure; Sedation; Analgesia; Complication; Quality control; |
中文摘要 | 在加護病房的病人常需要接受許多診斷性或治療性的侵入性技術,這些處置會帶給病人額外的疼痛,疼痛所引發的生理壓力反應及心理折磨會帶給病人傷害,但重症病人的血流動力常處在不穩定的狀態,給鎮靜止痛藥物後發生相關併發症的機會比較高。因此我們所努力的目標是如何有效、安全及人性化地執行侵入性技術的鎮靜與止痛。要達成這個目標我們需要建立一個完整的臨床準則,這個臨床準則應包含下列事項:首先要定義鎮靜程度與評估方法,評估病人接受鎮靜止痛前的身體狀況,做好執行鎮靜止痛前之準備,熟悉使用藥物的藥物動力學與藥物作用學,預防並處理可能發生的併發症,最後還要有醫療品質管理計畫,由專責單位追蹤檢視併發症發生率,分析原因修改用藥建議與注意事項。未來希望繼續研究有關新的藥物、給藥方式及客觀監測鎮靜程度方法,進一步提升整體鎮靜止痛品質及病人安全。 |
英文摘要 | Patients in critical care units often require diagnostic or therapeutic invasive procedures; however, these procedures bring more pain upon patients. Psychological and physiological responses to pain can be detrimental; therefore, adequate sedation and pain relieve is useful during invasive procedures. Since critically ill patients are more likely associated with hemodynamic instability, the administration of analgesics and sedatives should be very careful. Our goal is to effectively and safety perform invasive procedure under adequate sedation and pain relieve. To achieve such goal, we must have a clinical practice guideline which includes following steps: to define the level of sedation; to evaluate the patient's physical status before sedation; to prepare the patient before drug administration; to familiarize with drugs' pharmacology; to avoid possible complication. In addition, we should provide quality control through regular follow up to reduce complications. With the advance of new drugs, techniques, and monitoring, we try to improve the quality of sedation and analgesia and to maximize patient safety. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。