酮酚与乙托芬在肩关节前脱位复位手术镇静镇痛中的比较：一项随机试验

IF 2 3区医学 Q3 CRITICAL CARE MEDICINE

Injury-International Journal of the Care of the Injured Pub Date : 2025-09-30 DOI:10.1016/j.injury.2025.112777

Mojtaba Habibi-Khorasani, Masoomeh Nazemi-Rafi, Amirhossein Mirafzal, Mitra Movahedi, Amin Honarmand

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引用次数: 0

摘要

背景：前肩脱位在急诊情况下很常见，需要有效的镇静镇痛（PSA）。酮酚（氯胺酮-异丙酚）和乙托芬（依托米特-芬太尼）被广泛使用，但它们的相对疗效仍有争议。目的本研究的目的是比较酮酚和乙托芬在肩关节脱位复位中的PSA的疗效和安全性。方法随机临床试验纳入92例患者（每组46例）。给予酮酚（0.75 mg/kg）或乙托芬（0.15 mg/kg依托咪酯+ 1.5µg/kg芬太尼）。结果包括镇静深度、血流动力学、不良事件和恢复时间。结果酮fol具有较深的镇静作用（RSS 4.5 vs. 4.1, p < 0.001），较好的镇痛作用（VAS 1.64 vs. 2.64, p < 0.001），较容易复位，但有较多的急诊反应。依托芬发作更快，呼吸事件较少，但引起肌阵挛。结论酮酚具有良好的镇痛和镇静作用，而乙托芬具有快速恢复和血流动力学稳定的作用。选择取决于临床重点。临床试验注册：irct20220824055790n1。

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Comparing ketofol with etofen in procedural sedation analgesia for anterior shoulder dislocation reduction: A randomized trial

Background

Anterior shoulder dislocations are common in emergency settings, requiring effective procedural sedation and analgesia (PSA). Ketofol (ketamine-propofol) and etofen (etomidate-fentanyl) are widely used, but their comparative efficacy remains debated.

Objectives

The aim of this study was to compare the efficacy and safety of ketofol versus etofen for PSA in shoulder dislocation reduction.

Methods

This randomized clinical trial enrolled 92 patients (46 per group). Ketofol (0.75 mg/kg) or etofen (0.15 mg/kg etomidate + 1.5 µg/kg fentanyl) was administered. Outcomes included sedation depth, hemodynamics, adverse events, and recovery times.

Results

Ketofol provided deeper sedation (RSS 4.5 vs. 4.1, p < 0.001), better analgesia (VAS 1.64 vs. 2.64, p < 0.001), and easier reduction but had more emergence reactions. Etofen showed faster onset and fewer respiratory events but caused myoclonus.

Conclusion

Ketofol offers superior analgesia and sedation, while etofen ensures rapid recovery and hemodynamic stability. The choice depends on clinical priorities.

Clinical trial registration

IRCT20220824055790N1.

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来源期刊

Injury-International Journal of the Care of the Injured 医学-急救医学

CiteScore

4.00

自引率

8.00%

发文量

699

审稿时长

96 days

期刊介绍： Injury was founded in 1969 and is an international journal dealing with all aspects of trauma care and accident surgery. Our primary aim is to facilitate the exchange of ideas, techniques and information among all members of the trauma team.