右美托咪定、氯胺酮和依托咪酯在白内障超声乳化手术中的镇静、血流动力学和麻醉效果的比较:一项随机临床试验。

IF 1.2 Q3 OPHTHALMOLOGY
Bardia Moghisseh, Hesameddin Modir, Esmail Moshiri, Zahra Motaghinia, Mohammadreza Bozorgmanesh
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引用次数: 0

摘要

目的:比较右美托咪定、氯胺酮和依托咪酯对超声乳化白内障手术患者镇静和血流动力学改变的诱导作用。方法:对128例患者进行双盲临床研究。采用分组随机法,将患者分为4组(右美托咪定、氯胺酮、依托咪酯和对照组)。术中、恢复时及术后1、2、4、6 h每5 min记录一次平均动脉压、心率、动脉血氧饱和度、Ramsay镇静评分。此外,从恢复室出院的恢复时间测量Aldrete评分。结果:参与者平均年龄为63.16±6.07岁,年龄、性别、体质量指数、SpO2、心率组间差异无统计学意义(P > 0.05)。手术开始后15 min至术后6 h,右美托咪定组平均动脉压显著低于氯胺酮、依托咪酯和对照组(P < 0.05)。右美托咪定组恢复期和术后1 h平均镇静评分(Ramsay)高于对照组,恢复时间显著高于其他组(P < 0.001)。此外,右美托咪定和氯胺酮两组患者异丙酚用量显著低于依托咪酯组和对照组(P < 0.001)。结论:结果显示,右美托咪定对血流动力学的影响较好,血压和心率下降幅度更大,且右美托咪定组患者不需要任何特殊的药物治疗。此外,与其他研究组相比,右美托咪定组患者满意度更高,恢复时间更长。因此,建议在白内障手术中使用右美托咪定作为辅助剂,以获得更多的镇静、镇痛和最佳的术中条件。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Comparison of the Sedative, Hemodynamic, and Anesthetic Effect of Dexmedetomidine, Ketamine, and Etomidate on Cataract Surgery by Phacoemulsification Method: A Randomized Clinical Trial.

Comparison of the Sedative, Hemodynamic, and Anesthetic Effect of Dexmedetomidine, Ketamine, and Etomidate on Cataract Surgery by Phacoemulsification Method: A Randomized Clinical Trial.

Comparison of the Sedative, Hemodynamic, and Anesthetic Effect of Dexmedetomidine, Ketamine, and Etomidate on Cataract Surgery by Phacoemulsification Method: A Randomized Clinical Trial.

Comparison of the Sedative, Hemodynamic, and Anesthetic Effect of Dexmedetomidine, Ketamine, and Etomidate on Cataract Surgery by Phacoemulsification Method: A Randomized Clinical Trial.

Purpose: To compare dexmedetomidine, ketamine, and etomidate in the induction of sedation and hemodynamic changes in patients undergoing cataract surgery by phacoemulsification method.

Methods: This was a double-blind clinical trial study carried out on 128 patients. Using the block randomization method, the patients were divided into four equal groups (dexmedetomidine, ketamine, etomidate, and control). Mean arterial pressure, heart rate, and arterial oxygen saturation, Ramsay Sedation Score were recorded every 5 min intraoperatively, in recovery, and 1, 2, 4, and 6 h postoperatively. Moreover, the Aldrete score was measured in recovery time for discharge from the recovery room.

Results: The mean age of participants was found to be 63.16 ± 6.07 years, and there was no statistically significant difference between the groups in terms of age, sex, and body mass index, SpO2, and heart rate (P > 0.05). From 15 min after the start of surgery to 6 h postoperatively, the mean arterial pressure in the dexmedetomidine group was significantly lower than that in the other three groups, including ketamine, etomidate, and control (P < 0.05). The mean sedation score (Ramsay) during recovery and 1 h postoperatively was higher in the dexmedetomidine group compared with that in the control group, whereas the recovery time in the dexmedetomidine group was higher than that in the other groups (P < 0.001). In addition, the amount of propofol consumption in the two groups of dexmedetomidine and ketamine was significantly less than that in the etomidate and control groups (P < 0.001).

Conclusions: According to the results, dexmedetomidine caused better hemodynamic changes with more reduction in blood pressure and heart rate, and patients in the dexmedetomidine group did not require any specific medical treatment. Moreover, higher patient satisfaction and longer recovery duration were observed in the dexmedetomidine group than in the other study groups. As such, it is suggested that dexmedetomidine be used as an adjuvant in cataract surgery for more sedation, analgesia, and optimal intraoperative conditions.

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来源期刊
CiteScore
2.50
自引率
6.70%
发文量
45
审稿时长
8 weeks
期刊介绍: Peer Review under the responsibility of Iranian Society of Ophthalmology Journal of Current Ophthalmology, the official publication of the Iranian Society of Ophthalmology, is a peer-reviewed, open-access, scientific journal that welcomes high quality original articles related to vision science and all fields of ophthalmology. Journal of Current Ophthalmology is the continuum of Iranian Journal of Ophthalmology published since 1969.
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