# 在使用midazolam-fentanyl進行大腸鏡意識鎮靜期間，個案SpO2降至84%，呼吸每分鐘6次且淺。優先介入組合是什麼？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391881&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

在使用midazolam-fentanyl進行大腸鏡意識鎮靜期間，個案SpO2降至84%，呼吸每分鐘6次且淺。優先介入組合是什麼？

## 選項

1. 靜脈給予atropine
2. 繼續程序並再給midazolam
3. 讓個案仰臥並觀察
4. 停止追加鎮靜、給氧、支持通氣（必要時下顎上提/袋瓣面罩），準備flumazenil逆轉benzodiazepine與naloxone逆轉opioid **✔ 正確答案**

**正確答案: 4**

## 解析

正確（2）：意識鎮靜期間，護理師必須持續監測，遇到呼吸抑制需立即介入：停止鎮靜藥、補充氧氣、支持通氣、準備逆轉藥。Flumazenil用於benzodiazepine（midazolam），naloxone用於opioid（fentanyl）。（1,3,4）不適當。

## 深入解析

記憶提示 意識鎮靜 =「midazolam + fentanyl + 逆轉藥備妥（flumazenil + naloxone）」。Capnography比只看SpO2更佳。停止、支持、逆轉。

## 臨床情境

情境 65歲女性接受大腸鏡，使用midazolam + fentanyl；SpO2 84%、RR 6。

## 重要概念

- **意識（中度）鎮靜** — 意識降低但仍維持氣道與反應；常用於內視鏡/程序。
- **Flumazenil拮抗藥** — Benzodiazepine拮抗劑；逆轉midazolam造成的呼吸抑制。
- **Capnography二氧化碳監測** — 連續監測EtCO2；可在SpO2下降前偵測低通氣。

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