Department of Anaesthesiology, Baskent University, Dadaloğlu, Turkey.
J Anesth. 2012 Jun;26(3):351-6. doi: 10.1007/s00540-012-1335-4. Epub 2012 Feb 17.
Electroshock wave lithotripsy (ESWL) is a painful procedure performed with sedoanalgesia in paediatric patients. The propofol-ketamine combination may be the preferable anaesthesia for this procedure, and propofol-ketamine consumption may be decreased with the administration of intravenous (IV) paracetamol. In this study we investigated the effect of IV paracetamol administration on propofol-ketamine consumption, recovery time and frequency of adverse events in paediatric patients undergoing ESWL.
Sixty children, ranging in age from 1 to 10 years and with American Society of Anesthesiologists Physical Status 1-2, were included in this prospective, randomized, double-blinded study. Thirty minutes prior to the procedure children randomly assigned to Group I received IV 15 mg/kg paracetamol, and those randomly assigned to Group II received 1.5 mL/kg IV saline infusion 30 min. The propofol-ketamine combination was prepared by mixing 25 mg propofol and 25 mg ketamine in a total 10 mL solution in the same syringe. After the administration of 0.1 mg/kg midazolam and 10 μg/kg atropine to both groups and during the procedure, the propofol-ketamine combination was administered at 0.5 mg/kg doses to achieve a Wisconsin sedation score of 1 or 2. Oxygen saturation and heart rate were recorded at 5-min intervals. Propofol-ketamine consumption, recovery times and adverse events were also recorded.
Demographic data were similar between groups. Propofol-ketamine consumption (Group I, 25.2 ± 17.7 mg; Group II, 35.4 ± 20.1 mg; p = 0.04) and recovery times (Group I, 19.4 ± 7.9 min; Group II, 29.6 ± 11.4 min; p < 0.0001) were significantly different between groups. Saturation, heart rate and adverse events were similar in both groups.
Our data suggest that the administration of IV paracetamol decreases propofol-ketamine consumption for adequate sedation during ESWL procedures in paediatric patients and shortens recovery time.
体外冲击波碎石术（ESWL）是一种在儿科患者中进行的伴有镇静镇痛的痛苦操作。异丙酚-氯胺酮联合用药可能是该操作的首选麻醉方法，而静脉注射（IV）扑热息痛的给药可能会减少异丙酚-氯胺酮的消耗。在这项研究中，我们研究了 IV 扑热息痛给药对接受 ESWL 的儿科患者异丙酚-氯胺酮消耗、恢复时间和不良事件频率的影响。
60 名年龄在 1 至 10 岁之间、美国麻醉医师协会身体状况 1-2 级的儿童被纳入这项前瞻性、随机、双盲研究。在操作前 30 分钟，随机分为 I 组的儿童接受 IV 15 mg/kg 扑热息痛，随机分为 II 组的儿童接受 30 分钟 IV 生理盐水 1.5 mL/kg 输注。将 25 mg 异丙酚和 25 mg 氯胺酮混合在同一注射器中的 10 mL 溶液中制备异丙酚-氯胺酮混合物。在两组儿童给予 0.1 mg/kg 咪达唑仑和 10 μg/kg 阿托品后，并在操作过程中，给予 0.5 mg/kg 异丙酚-氯胺酮混合物，以达到威斯康星镇静评分 1 或 2。以 5 分钟的间隔记录氧饱和度和心率。还记录了异丙酚-氯胺酮的消耗、恢复时间和不良事件。
两组的人口统计学数据相似。异丙酚-氯胺酮的消耗（I 组，25.2 ± 17.7 mg；II 组，35.4 ± 20.1 mg；p = 0.04）和恢复时间（I 组，19.4 ± 7.9 min；II 组，29.6 ± 11.4 min；p < 0.0001）在两组之间有显著差异。两组的饱和度、心率和不良事件相似。
我们的数据表明，在儿科患者的 ESWL 操作中，IV 扑热息痛的给药可减少异丙酚-氯胺酮的消耗以达到充分镇静，并缩短恢复时间。
