Kirikkale University, School of Medicine, Department of Anesthesiology and Reanimation, Kirikkale, Turkey.
Urology. 2012 Jun;79(6):1214-9. doi: 10.1016/j.urology.2012.02.040.
To compare the effects of dexmedetomidine-ketamine and dexmedetomidine-midazolam combinations on the recovery time, hemodynamic and respiratory variables, and side effects in patients undergoing transurethral procedures.
Sixty patients scheduled for elective outpatient transurethral procedure were randomized into 2 groups. In the group K, a ketamine-dexmedetomidine combination was administered, and in the group M, midazolam-dexmedetomidine was administered, to provide sedation/analgesia. Pain and sedation levels were assessed using visual analog score (VAS) and Ramsey Sedation Scale, respectively. The recovery time was assessed with the scale of Aldrete. Time was measured and recorded to the moment at which patient responses brought the Aldrete score to 10 points. Time to eye opening and length of stay in the recovery room were recorded.
Group M showed significantly lower mean arterial pressure (MAP) values at 5 and 10 minutes during the procedure when compared with group K (P = .02 and P = .01, respectively). Visual analogue scale scores were greater in group M than in group K at 5 and 10 minutes for the transurethral procedure (P = .039 and P = .028, respectively). Sedation scores were similar between groups during the procedure. Time to eye opening and length of recovery room stay were shorter (P < .001 and P < .001, respectively), and Aldrete scores were greater in group K than group M.
Both combinations provided satisfactory sedation levels, but the dexmedetomidine-ketamine combination provided better analgesia and hemodynamic stability, with less nausea and vomiting and shorter recovery time, than the dexmedetomidine-midazolam combination.
比较右美托咪定-氯胺酮和右美托咪定-咪达唑仑组合对接受经尿道手术患者的恢复时间、血流动力学和呼吸变量以及副作用的影响。
将 60 名计划接受择期门诊经尿道手术的患者随机分为 2 组。在 K 组中，给予氯胺酮-右美托咪定组合，在 M 组中，给予咪达唑仑-右美托咪定组合，以提供镇静/镇痛。使用视觉模拟评分（VAS）和 Ramsay 镇静评分分别评估疼痛和镇静水平。使用 Aldrete 量表评估恢复时间。测量并记录从患者反应使 Aldrete 评分达到 10 分的那一刻到那一刻的时间。记录睁眼时间和恢复室停留时间。
与 K 组相比，M 组在手术期间的 5 分钟和 10 分钟时的平均动脉压（MAP）值明显更低（P =.02 和 P =.01）。与 K 组相比，M 组在经尿道手术的 5 分钟和 10 分钟时的视觉模拟评分更高（P =.039 和 P =.028）。在手术过程中，两组的镇静评分相似。睁眼时间和恢复室停留时间更短（P <.001 和 P <.001），K 组的 Aldrete 评分高于 M 组。
两种组合都提供了令人满意的镇静水平，但与右美托咪定-咪达唑仑组合相比，右美托咪定-氯胺酮组合提供了更好的镇痛和血流动力学稳定性，恶心和呕吐更少，恢复时间更短。
