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頁籤選單縮合
題 名 | Selective Use of Midazolam for Conscious Sedation during Colonoscopy=選擇導美睡(Midazolam)用於大腸鏡檢之鎮靜 |
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作 者 | 劉文欽; 林資琛; 徐弘; | 書刊名 | 中華民國外科醫學會雜誌 |
卷 期 | 25:5 民81.09-10 |
頁 次 | 頁1337-1341 |
分類號 | 416.245 |
關鍵詞 | 大腸鏡檢; 導美睡; 鎮靜; Midazolam; |
語 文 | 英文(English) |
中文摘要 | 目前大腸鏡檢例行使用鎮靜劑已很普遍,但它的需要性及有效性卻尚未證質,因此我們對於因大腸鏡檢覺得疼痛難忍之病人選擇使用導美睡五毫克靜脈一次注射作一研究。從1990年3月至12月,共有773個大腸鏡檢之病人,在沒有鎮靜的情況下,166(22%)個病人無法完成此項檢查,其中81(50.3%)個病人因疼痛難忍,52(32.3%)個病人因大腸準備不夠徹底,28(17.3%)個病人因其他技術上的問題,如:困難性大腸,手術後黏連,或病人狀況不好等等;而在這81個因疼痛難忍而鏡檢失敗的病人,有24(29.6%)個病人願意接受靜注射導美睡五毫克,以繼續完成大腸鏡檢,這24個病人中,有20(83%)個病人因靜脈注射後完成這項檢查,而4(17%)個病人仍然失敗,由此看來對於一開始是因為疼痛而無法完成大腸鏡檢之病人,使用導美睡五毫克鎮靜,可幫助約83%的大腸鏡檢之完成。而此鎮靜劑的使用對病人心跳,血壓及呼吸,均無太大的影響,其作用迅速,藥物作用期間短,無臨床意義上的副作肘,此研究顯示鎮靜劑導美睡的使用,對大腸鏡檢具有很好的耐受性及有效性。 |
英文摘要 | Routine sedation during colonoscopic examination is a common practice by endoscopists. However, its necessity and efficacy has not been proved definitely. A prospective study was done, using intravenous bolus injection of 5mg midazolam only if patient suffered from intolerable pain during the examination. From March to December, 1990, 733 consecutive colonoscopic examinations were performed either by the authors or under their supervision. Without sedation, 161 patients (22%) were unable to complete the examination. Among those, 81 patients (50.3%) suffered intolerable pain, 52 patients (32.3%) had had inadequate colonic preparation; 28 patients (17.3%) failed because of technical problems such as acute angulation or redundancy of the colon which made impossible passage by external compression, straightening or rotation of the colonoscope, a post-operative adhesion or unstable general condition. Of the patients who suffered intolerable pain, 24 patients (29.6%) consented to receive intravenous sedation with midazolam in order to continue the procedure. Of those 24, 20 (83%) completed the examination successfully; 4 (17%) still failed. Midazolam can help to complete a colonoscopic examination in about 83% of patients if the only initial difficulty is pain. There were mild changes in blood pressure and heart rate, but no change in respiratory rate, in those to whom midazolam was administered. The onset of sedation was about two minutes; its duration was about 0.5 to 2.5 hours. No undesirable effects were reported by patients. This study demonstrated the efficiency and patient-tolerance of midazolam for colonoscopic procedure. |
本系統中英文摘要資訊取自各篇刊載內容。