词条 | Sedation |
释义 |
Medical usesSedation is typically used in minor surgical procedures such as endoscopy, vasectomy, or dentistry and for reconstructive surgery, some cosmetic surgeries, removal of wisdom teeth, or for high-anxiety patients.[2] Sedation methods in dentistry include inhalation sedation (using nitrous oxide), oral sedation, and intravenous (IV) sedation. Inhalation sedation is also sometimes referred to as relative analgesia. Sedation is also used extensively in the intensive care unit so that patients who are being ventilated tolerate having an endotracheal tube in their trachea. Also can be used during a long term brain EEG to help patient relax. RisksThere are studies claiming that sedation accounts for 40 percent to 50 percent procedure-related complications, that is why this process has attracted attention.[3] Airway obstruction, apnea and hypotension are not uncommon during sedation and require the presence of health professionals who are suitably trained to detect and manage these problems. Aside from the suppression of respiration, risks also include unintended levels of sedation, postoperative somnolence, aspiration,[4] and adverse reactions to sedation medications.[5] Complications could also include perforation, bleeding, and the stimulation of vasovagal reflexes.[6] To avoid sedation risks, care providers conduct a thorough pre-sedation evaluation and this process includes pre-sedation history and physicals with emphasis on the determining characteristics that indicate potential risks to the patient and potential difficult airway management.[7] This process can also reveal if the sedation period needs to be prolonged or additional therapeutic procedures are required.[8] Levels of sedationSedation scales are used in medical situations in conjunction with a medical history in assessing the applicable degree of sedation in patients in order to avoid under-sedation (the patient risks experiencing pain or distress) and over-sedation (the patient risks side effects such as suppression of breathing, which might lead to death). Examples of sedation scales include MSAT (Minnesota Sedation Assessment Tool), UMSS (University of Michigan Sedation Scale), the Ramsay Scale (Ramsay, et al. 1974) and the RASS (Richmond Agitation-Sedation Scale). The American Society of Anesthesiologists defines the continuum of sedation as follows:[9]
In the United Kingdom, deep sedation is considered to be a part of the spectrum of general anesthesia, as opposed to conscious sedation. Patient screening process{{Unreferenced section|date=September 2018}}Prior to any oral sedation methods being used on a patient, screening must be done to identify possible health concerns. Before using sedation, doctors try to identify any of the following that may apply: known drug allergies and sensitivities, hypertension, heart defects, kidney disease, other allergens, such as latex allergy, history of stroke or transient ischemic attack (TIA) (certain oral sedation methods may trigger a TIA), neuromuscular disorders (such as muscular dystrophy), or a current list of medications and herbal supplements taken by the patient. A patient with any of these conditions must be evaluated for special procedures to minimize the risk of patient injury due to the sedation method. In addition to the aforementioned precautions, patients should be interviewed to determine if they have any other condition that may lead to complications while undergoing treatment. Any head, neck, or spinal cord injuries should be noted as well as any diagnosis of osteoporosis. See also{{Wiktionary pipe|sedate#Verb|sedate}}
References1. ^{{Cite journal | last1 = Brown | first1 = TB. | last2 = Lovato | first2 = LM. | last3 = Parker | first3 = D. | title = Procedural sedation in the acute care setting | journal = Am Fam Physician | volume = 71 | issue = 1 | pages = 85–90 |date=Jan 2005 | pmid = 15663030 }} 2. ^{{cite web|url=http://www.honoluludentalpractice.com/services/sedation-dentistry-honolulu/ |title=Sedation Dentistry for Anxious Patients |accessdate=2014-09-11}} 3. ^{{Cite book|title=Sedation and Monitoring in Gastrointestinal Endoscopy, An Issue of Gastrointestinal Endoscopy Clinics of North America|last=Vargo|first=John|publisher=Elsevier Health Sciences|year=2016|isbn=9780323448451|location=Philadelphia, PA|pages=465}} 4. ^{{Cite book|title=Practical Guide to Moderate Sedation/analgesia|last=Odom-Forren|first=Jan|last2=Watson|first2=Donna|publisher=Elsevier Mosby|year=2005|isbn=0323020240|location=St. Louis, MO|pages=84}} 5. ^{{Cite book|title=Sedation and Monitoring in Gastrointestinal Endoscopy, An Issue of Gastrointestinal Endoscopy Clinics of North America|last=Vargo|first=John|publisher=Elsevier Health Sciences|year=2016|isbn=9780323448451|location=Philadelphia, PA|pages=554}} 6. ^{{Cite book|title=Conscious Sedation: A Handbook for Nurse Practitioners|last=Skelly|first=Meg|last2=Palmer|first2=Diane|publisher=Whurr Publishers|year=2006|isbn=1861562667|location=London|pages=69}} 7. ^{{Cite book|title=Pediatric Sedation Outside of the Operating Room: A Multispecialty International Collaboration|last=Mason|first=Keira|publisher=Springer|year=2011|isbn=9780387097138|location=New York|pages=166}} 8. ^{{Cite book|title=Pediatric Gastrointestinal Endoscopy: Textbook and Atlas|last=Winter|first=Harland|last2=Murphy|first2=Stephen|last3=Mougenot|first3=Jean Francois|last4=Cadranel|first4=Samy|publisher=BC Decker Inc.|year=2006|isbn=1550092235|location=Hamilton, Ontario|pages=59}} 9. ^{{cite web|title=Continuum of Depth of Sedation: Definition of general anesthesia and levels of sedation/analgesia |url=http://www.asahq.org/For-Healthcare-Professionals/~/media/For%20Members/documents/Standards%20Guidelines%20Stmts/Continuum%20of%20Depth%20of%20Sedation.ashx |format=pdf |publisher=American Society of Anesthesiologists |date=21 October 2009 |accessdate=2010-11-29}} 1 : Anesthesia |
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