清醒鎮靜在腸胃內視鏡的應用

Conscious Sedation in Gastrointestinal Endoscopy

在台灣地區這幾年來，胃癌和大腸癌的發生率已躍居所有癌症的前五名。由於腸胃內視鏡檢查是早期診斷的絕佳方法，因此定期接受檢查，就健康的觀點而言，無疑是明智的選擇。然而，檢查中不愉快和可怕的經驗，卻令許多人無法接受。甚至連疑似癌症的病患，恐怕也因此錯失診斷的先機。現在，麻醉醫師會在檢查的過程中加入鎮靜和止痛劑，可達到所謂”清醒鎮靜”的效果。如此一來，不僅普遍增加病患的接受度，同時更增加整個檢查過程的滿意度。本文針對相關的議題包括實施鎮靜前的評估、準備、用藥以及併發症等，做一個綜合性的回顧與討論。

In recent years, the incidences of stomach and colon cancers have ranked within the top fives of all malignancies in Taiwan. To say healthwise, regular gastrointestinal (GI) endoscopic examinations are recommended, as they are the best way for early detection. However, unpleasantness of and terrible experience from the examination greatly discourage the acceptance of many people even of the suspected groups. Now, the administration of sedative or analgesic to achieve the so called 'conscious sedation” during GI endoscopy which brings about better tolerability and improves general acceptance offers a more satisfactory service. In this article, the related issues about prepro-cedure evaluation, preparation, medications and complications of conscious sedation in GI endoscopy are discussed after review.