진정요법의 문제점: 약물의 선택과 안전성

Abstract

With increasing interest towards the proper management of the patient's anxiety and pain during diagnostic and therapeutic procedures, adequate sedation has become an essential part of a successful procedure. Due to recent advancements in modern medicine, many surgical procedures that were once done under general anesthesia are being increasingly replaced by minimally invasive procedures that are performed under sedation. However, the duration or degrees of pain that are caused by different types of procedures vary extensively. Some procedures are easily done under only light sedation, while others require extensive pain control and deeper sedation. Comfort and safety are essential components of 'successful sedation', and full understanding of the degree of pain and the physiologic changes that the procedure may cause is needed in order to offer this to the patient. The depth of sedation should be controlled with proper sedatives while adequate analgesia should be offered according to type of procedure. Choice and doses of drugs should always be tailored to the patient's general condition, and additional administrations should be done after the effect of the previous dose is observed in order to avoid overdosing. When combining sedatives and/or analgesics, the possible synergistic effects between different drugs should always be kept in mind. In order to choose the adequate type and dose of drug, knowledge regarding the pharmacodynamic and pharmacokinetic properties of commonly used drugs for procedures is needed for safe and effective sedation.