Empfehlung zur Sedierung in der flexiblen Bronchoskopie

Zusammenfassung

Die flexible Bronchoskopie ist heute eine Standarduntersuchung und wird nicht nur in fast allen Kliniken, sondern auch im niedergelassenen Bereich durchgeführt. Der überwiegende Teil der Patienten wünscht für diese Untersuchung eine Sedierung. Eine solche ist bei komplexen und interventionellen Eingriffen, unabhängig von dem Wunsch des Patienten, praktisch immer erforderlich. Die vorliegende Empfehlung zur Anwendung sedierender Maßnahmen in der flexiblen Bronchoskopie basiert auf den Ergebnissen zahlreicher klinischer Studien, berücksichtigt aber auch die individuellen Erfahrungen in diesem Bereich. Die Struktur- und Prozessvoraussetzungen sowie die Anforderungen an die Ausbildung des Personals werden definiert und sollen den Mindeststandard bei der Durchführung einer Bronchoskopie unter Sedierung beschreiben. Darüber hinaus werden die zur Sedierung empfohlenen Pharmaka diskutiert und deren Applikationsarten dargestellt. Schließlich beinhalten die Empfehlungen auch Vorschläge zur Aufklärung, Überwachung und Entlassung der Patienten. Sie sollen dem Untersucher konkrete Handlungsmöglichkeiten aufzeigen und damit vor allem die Patientensicherheit erhöhen.

Abstract

Flexible bronchoscopy is a standard examination today and is conducted not only in nearly every hospital but also in privately owned practices. The vast majority of patients want sedation for this examination. Such a procedure is nearly always necessary in complex and interventional procedures, irrespective of the patient’s wish. The recommendation at hand to use sedation measures for flexible bronchoscopy is based on the results of numerous clinical studies and also takes account of individual experiences in this area. The structural and procedural requirements and the requirements for staff training are defined and should describe the minimum standard when it comes to conducting a bronchoscopy under sedation. Furthermore the drugs recommended for sedation are discussed and their methods of application shown. Finally the recommendations also include suggestions for patient clarification, monitoring and discharge. They should provide the examiner with concrete operating options and therefore above all increase patient safety.

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