개원가에서의 안전한 진정

Abstract

Procedural sedation and analgesia are now becoming more frequently required and procedural safety is one of the main interests of private clinic physicians. Efforts to establish safe sedation and analgesia include patient assessment to avoid sedating patients with risk factors, training for drug administration, airway management, and treatment of adverse effects, proper preparation of monitoring and resuscitation equipments and recovery facility, thorough recording of the sedation process as well as the procedure itself, analysis of results and quality assessment. Complications during procedural sedation and analgesia, including nausea and vomiting, respiratory depression, hypoxia and even cardiac arrest, should be prevented and properly treated. In this review, basic requirements for procedural sedation and analgesia are to be described, such as sedatives/analgesics including propofol, midazolam, ketamine, etomidate and dexmedetomidine, and airway management with ventilatory support for respiratory depression. Most of all, proper education and repeated training for airway management with ventilatory support and cardiopulmonary resuscitation are critically important for all the personnel involving the procedural sedation and analgesia.