[临终镇静的药物治疗]。

IF 0.1 Q4 NURSING
Revista Rol de Enfermeria Pub Date : 2017-02-01
Rocío Domínguez Álvarez, Manuel Mejías Estéve, José María Galán González-Serna
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引用次数: 0

摘要

目的:通过主要干预措施控制临终患者的躯体症状。本文就姑息性镇静的临床护理情况及常用药物管理中的相关问题进行综述。方法:选取Scopus、CINAHL、Medline-PubMed、Google Scholar等科学文献检索推荐的姑息性镇静护理管理,关键词为“Palliative Sedation”、“pharmacology”、“Nursing care”、“Palliative care”。结果:姑息性镇静(palliative sedation, PS)的目的是降低患者的意识水平,以减轻临终患者的强烈痛苦,如难治性谵妄或呼吸困难、大出血、抽搐状态、死前爆裂或难治性心理痛苦。PS的选择途径是皮下注射(sc)。镇静的一线药物是咪达唑仑和左旋丙嗪。阿片类药物应保持等镇痛剂量,氯吗啡是最广泛使用的。护理在SP中的基本作用是根据Ramsay量表(或类似量表)监测镇静水平,识别指示性不适迹象,以便给予抢救镇静或镇痛药物和/或筛选可治疗的并发过程(膀胱膨胀、便秘、梗阻方式、最终剂量效应等)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Pharmacological Treatment in End-of-Life Sedation].

Objective: To control the physical symptoms in end-of-life pharmacological management involves major intervention. The aim of this article is to review the relevant issues in the management of clinical nursing situation and drugs commonly used in palliative sedation in agony.

Methodology: Nursing management in Palliative Sedation recommended by scientific literature search in Scopus, CINAHL, Medline-PubMed and Google Scholar, with key words "palliative sedation", "pharmacology", "nursing care" and "palliative care" are selected.

Results: The goal of palliative sedation (PS) is to reduce the level of consciousness as the only way to relieve intense suffering in terminally ill patients, such as refractory delirium or dyspnea, massive bleeding, convulsive status, crackles premortem or refractory psychological suffering. The route of choice in PS is subcutaneous injection (sc). First line drugs in sedation are midazolam and levomepromazina. Opioids should be kept at equi-analgesic doses, morphine chloride being the most widely used. The fundamental role of nursing in SP is monitoring the level of sedation based on the Ramsay scale (or similar) and recognition of the indicative signs of discomfort for administration rescue sedative or analgesic medication and/or screening treatable intercurrent process (distended bladder, constipation, obstruction way, final dose effect, etc.).

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来源期刊
自引率
0.00%
发文量
25
期刊介绍: Revista ROL de Enfermería es una publicación abierta a todos aquellos trabajos que tengan como objetivo contribuir a la difusión del conocimiento científico en la atención de enfermería en sus diferentes ámbitos de actuación. Revista ROL de Enfermería considerará para su publicación los trabajos que dentro del marco general de las ciencias de la salud, tengan interés por los conocimientos e informaciones que aporten para contribuir al desarrollo y a la formación continuada de los profesionales de enfermería.
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