Abstract：
UNASSIGNED: Tracheostomy ventilation in motor neurone disease is an uncommon life-sustaining treatment. Best practice is having a plan for ventilation withdrawal, but the literature to guide practice is limited. Case reports have documented standard doses of opioids and benzodiazepines used for sedation in such cases.
UNASSIGNED: A 49-year-old man was diagnosed with motor neurone disease in 2016. He commenced tracheostomy ventilation in 2018. In 2022 and 2023, planning was undertaken, at the patient\'s request, for withdrawal of tracheostomy ventilation at home, when he was no longer able to communicate with technology.
UNASSIGNED: Planning included Bispectral Index monitoring prior to cessation of ventilation, ensuring this only occurred when deep sedation was achieved. After ventilation withdrawal in 2023, a retrospective review of medications given and his level of sedation on monitoring was undertaken, with family consent.
UNASSIGNED: Ventilation withdrawal was initiated after deep sedation was achieved, 6 h after commencing subcutaneous infusions of morphine, midazolam, clonazepam and phenobarbital.
UNASSIGNED: Doses required to achieve acceptable sedation exceeded literature reports. Achieving deep sedation was a longer than expected process.
UNASSIGNED: More research using an objective measure of sedation is required, as clinical assessment of sedation in this context is compromised.
UNASSIGNED: A 49-year-old man was diagnosed with motor neurone disease in 2016. He commenced tracheostomy ventilation in 2018. In 2022 and 2023, planning was undertaken, at the patient\'s request, for withdrawal of tracheostomy ventilation at home, when he was no longer able to communicate with technology.
UNASSIGNED: Planning included Bispectral Index monitoring prior to cessation of ventilation, ensuring this only occurred when deep sedation was achieved. After ventilation withdrawal in 2023, a retrospective review of medications given and his level of sedation on monitoring was undertaken, with family consent.
UNASSIGNED: Ventilation withdrawal was initiated after deep sedation was achieved, 6 h after commencing subcutaneous infusions of morphine, midazolam, clonazepam and phenobarbital.
UNASSIGNED: Doses required to achieve acceptable sedation exceeded literature reports. Achieving deep sedation was a longer than expected process.
UNASSIGNED: More research using an objective measure of sedation is required, as clinical assessment of sedation in this context is compromised.
摘要：
■气管切开通气在运动神经元疾病中是一种不常见的维持生命的治疗方法。最好的做法是制定通风退出计划，但是指导实践的文献是有限的。病例报告记录了在这种情况下用于镇静的标准剂量的阿片类药物和苯二氮卓类药物。
■一名49岁的男子在2016年被诊断出患有运动神经元疾病。他于2018年开始气管造口通气。2022年和2023年，进行了规划，应病人的要求，用于在家中退出气管造口通气，当他不再能够与技术交流时。
■计划包括停止通气前的双频谱指数监测，确保只有在实现深度镇静时才会发生这种情况。在2023年停止通气后，对给予的药物和他的镇静水平进行了回顾性审查。得到家人的同意。
■深度镇静后开始撤除通气，开始皮下注射吗啡后6小时，咪达唑仑,氯硝西泮和苯巴比妥.
■达到可接受的镇静作用所需的剂量超过了文献报道。实现深度镇静是一个比预期更长的过程。
■需要更多使用客观镇静措施的研究，因为在这种情况下对镇静的临床评估受到影响。
■一名49岁的男子在2016年被诊断出患有运动神经元疾病。他于2018年开始气管造口通气。2022年和2023年，进行了规划，应病人的要求，用于在家中退出气管造口通气，当他不再能够与技术交流时。
■计划包括停止通气前的双频谱指数监测，确保只有在实现深度镇静时才会发生这种情况。在2023年停止通气后，对给予的药物和他的镇静水平进行了回顾性审查。得到家人的同意。
■深度镇静后开始撤除通气，开始皮下注射吗啡后6小时，咪达唑仑,氯硝西泮和苯巴比妥.
■达到可接受的镇静作用所需的剂量超过了文献报道。实现深度镇静是一个比预期更长的过程。
■需要更多使用客观镇静措施的研究，因为在这种情况下对镇静的临床评估受到影响。
