比较丙泊酚联合氯胺酮与丙泊酚联合芬太尼用于内镜逆行胆管造影患者手术镇静的疗效

Dr. Keerthichandra Reddy K, D. Kv
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引用次数: 0

摘要

目的:比较异丙酚联合氯胺酮与异丙酚联合芬太尼用于ERCP患者手术镇静的疗效,评价异丙酚用量、恢复评分、患者满意度及镇静相关不良事件。材料与方法:年龄18 ~ 60岁,ASA I、II级患者60例,随机分为两组;异丙酚/氯胺酮(Ketofol)组KP (n=30)和异丙酚/芬太尼组FP (n=30)。调整镇静水平,使其达到Ramsay镇静量表(RSS) 5分。结果:FP组丙泊酚总用量(109.883±11.3871 mg)显著高于KP组(89.867±9.8942 mg)。与FP相比,KP组达到可接受恢复评分的时间稍长(30 min时Aldrete评分分别为9.5±0.509和9.8±0.407)。两组患者满意度相当,与KP组相比,FP组镇静相关的副作用如低血压、心动过缓、去血饱和度更显著。结论:异丙酚-氯胺酮联用镇静效果与异丙酚-芬太尼联用镇静效果相近,且血流动力学特征更好,副作用更小。因此异丙酚-氯胺酮联合用药可安全用于ERCP患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
to compare the efficacy of propofol with ketamine versus propofol with fentanyl for procedural sedation for patients undergoing endoscopic retrograde cholangiopancreatography
Objective: This study was conducted to compare the efficacy of Propofol with Ketamine versus Propofol with Fentanyl for procedural sedation for patients undergoing ERCP to evaluate Propofol consumption, recovery score, patient satisfaction and sedation related adverse events. Materials and Methods: Sixty patients aged 18-60 years, ASA Class I and II were randomly allocated to one of two groups; Propofol/Ketamine (Ketofol) group KP (n=30) and Propofol/Fentanyl group FP (n=30). The level of sedation was adjusted to achieve a Ramsay Sedation Scale (RSS) score of 5. Results: The total amount of Propofol consumed was significantly higher in FP group (109.883±11.3871 mg) compared to KP group (89.867±9.8942 mg). Time to reach acceptable recovery score was slightly longer in KP group compared to FP (Aldrete scores 9.5±0.509, 9.8±0.407 respectively at 30 min). Patient satisfaction was comparable in both the groups and sedation related side effects like hypotension, bradycardia, desaturation was more significant in FP group compared to KP group. Conclusion: Propofol-Ketamine combination provided sedation quality similar to Propofol-Fentanyl combination with better hemodynamic profile and fewer side effects. Hence Propofol-Ketamine combination can be safely used in patients undergoing ERCP.
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