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Procedural sedation and analgesia in outpatient with altered liver and renal function

Proceduralna sedacija i analgezija u ambulantnim uslovima kod bolesnika sa narušenom funkcijom jetre i bubrega

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Authors
Vasiljević, Slađana
Miličić, Biljana
Sabljak, Vera
Jozić, Irena
Stojanović, Marina
Marković, Dejan
Article (Published version)
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Abstract
Background. Procedural sedation is a technique of administering sedatives or dissociative agents with or without analgesics to induce a state of consciousness that allows the patient to tolerate unpleasant procedures while maintaining cardiorespiratory function. Short-acting sedatives, anesthetics and analgesics along with non-invasive monitoring enable safely performing of this technique in a variety of hospital settings and early discharge two hours after procedure. Case report. We present a technique of procedural sedation and analgesia in the outpatient setting for performing esophagogastroduodenoscopy in patient with terminal renal insufficiency who was on dialysis and liver cirrhosis. Conclusion. Procedural sedation and analgesia for esophagogastroduodenoscopy can be safely performed by a combination of fentanyl and propofol, which enables its use in patients with impaired renal and hepatic function. Careful titration of propofol provides a moderate level of sedation and safe and... efficient procedure performing.

Uvod. Proceduralna sedacija predstavlja tehniku primene sedativa i disocijativnih lekova, sa ili bez analgetika, u cilju promene stanja svesti koje bolesniku omogućava da toleriše neprijatne procedure, a da se pri tome ne narušava kardiorespiratorna funkcija. Za izvođenje ove vrste sedacije koriste se sedativi, analgetici i anestetici sa kratkim delovanjem, što uz neinvazivni monitoring, omogućava njeno bezbedno izvođenje u različitim bolničkim uslovima i rani otpust bolesnika, dva sata nakon procedure. Prikaz slučaja. U radu je prikazana tehnika proceduralne sedacije i analgezije u ambulantnim uslovima za izvođenje ezofagogastroduodenoskopije kod bolesnika sa terminalnom bubrežnom insuficijencijom koji je na programu dijalize i cirozom jetre. Zaključak. Proceduralna sedacija i analgezija za ezofagogastroduodenoskopiju se bezbedno izvodi kombinacijom fentanila i propofola, što omogućava njenu primenu i kod bolesnika sa umanjenom funkcijom jetre i bubrega. Pažljiva titracija propofola o...bezbeđuje umeren nivo sedacije i bezbedno i efikasno izvođenje procedure.

Keywords:
procedural sedation and analgesia / endoscopy / terminal renal failure / liver cirrhosis / proceduralna sedacija i analgezija / endoskopija / terminalna bubrežna insuficijencija / ciroza jetre
Source:
Serbian Journal of Anesthesia & Intensive Therapy, 2014, 36, 3-4, 253-259
Publisher:
  • Udruženje anesteziologa i intenzivista Srbije, Beograd

ISSN: 2217-7744

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URI
http://smile.stomf.bg.ac.rs/handle/123456789/1941
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