Publication: Sedación en broncoscopia flexible. Estudio del perfil de seguridad y eficacia en dos cohortes de trabajo: Neumología y Anestesiología
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2021-07-19
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Universidad Complutense de Madrid
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Abstract
La broncoscopia es el procedimiento diagnóstico invasivo más frecuentemente realizado en Neumología. Es una técnica de escasa morbimortalidad, pero que por la propia naturaleza del procedimiento, ocasiona una situación de estrés, ansiedad y disconfort en el paciente que es sometido a ella. Por ello, en los últimos años se ha impuesto la realización del procedimiento broncoscópico con fármacos sedantes con la finalidad de mejorar la tolerancia y aceptabilidad al procedimiento, siendo algo que se realiza de rutina si no existen contraindicaciones para el uso de la sedación. La administración de dichos fármacos es realizada de forma habitual por los médicos especialistas en Anestesiología. Encontramos especialidades como Cardiología, Aparato Digestivo, Pediatría o Radiología, quienes ante determinados procedimientos, son los propios especialistas nombrados quienes administran la medicación sedante al paciente, incluyendo el uso de propofol como fármaco principal de la sedación. En el caso de los neumólogos, la administración de medicación sedante para la realización de los procedimientos broncoscópicos ha sido un tema controvertido hasta hace unos años incluso dentro del propio gremio neumológico, aunque dichos especialistas cuenten con la formación y capacitación adecuada para el uso de sedante. En el momento actual, es una práctica aceptada en el mundo de la Neumología, aunque el uso de determinados fármacos sedantes como el propofol por médicos no anestesistas ni intensivistas, continúa siendo objeto de debate. En la actualidad, disponemos de diversas guías prácticas para la sedación por parte de médicos no anestesistas realizadas desde las propias sociedades de Anestesiología, y las guías americana y británica...
Bronchoscopy is the most frequently performed invasive diagnostic procedure in Pulmonology. It is a technique with low morbidity and mortality, but due to the nature of the procedure, it causes a situation of stress, anxiety and discomfort in the patient who undergoes it. For this reason, in recent years the bronchoscopic procedure with sedative drugs has been imposed in order to improve tolerance and acceptability to the procedure, being performed routinely if there are no contraindications to the use of sedation. The administration of these drugs is carried out on a regular basis by specialists in Anesthesiology. Specialties such as Cardiology, Gastroenterology, Pediatrics or Radiology, who, when faced with certain procedures, are the specialists themselves who administer the sedative medication to the patient, including the use of propofol as the main drug for sedation. In the case of Pulmonologists, the administration of sedative medication to carry out bronchoscopic procedures has been a controversial issue until a few years ago, even within the pulmonology guild, although these specialists have proper training for the use of sedatives. At the present time, it is an accepted practice in the world of Pulmonology, although the use of certain sedative drugs such as propofol by non-anesthesiologists or intensivists continues to be the subject of discussion. Nowadays, we have different practical guides for sedation by non-anaesthetists carried out by the Anesthesiology societies, and the American and British guidelines being the most important...
Bronchoscopy is the most frequently performed invasive diagnostic procedure in Pulmonology. It is a technique with low morbidity and mortality, but due to the nature of the procedure, it causes a situation of stress, anxiety and discomfort in the patient who undergoes it. For this reason, in recent years the bronchoscopic procedure with sedative drugs has been imposed in order to improve tolerance and acceptability to the procedure, being performed routinely if there are no contraindications to the use of sedation. The administration of these drugs is carried out on a regular basis by specialists in Anesthesiology. Specialties such as Cardiology, Gastroenterology, Pediatrics or Radiology, who, when faced with certain procedures, are the specialists themselves who administer the sedative medication to the patient, including the use of propofol as the main drug for sedation. In the case of Pulmonologists, the administration of sedative medication to carry out bronchoscopic procedures has been a controversial issue until a few years ago, even within the pulmonology guild, although these specialists have proper training for the use of sedatives. At the present time, it is an accepted practice in the world of Pulmonology, although the use of certain sedative drugs such as propofol by non-anesthesiologists or intensivists continues to be the subject of discussion. Nowadays, we have different practical guides for sedation by non-anaesthetists carried out by the Anesthesiology societies, and the American and British guidelines being the most important...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 10/02/2021