Khajavi Mohammadreza, Emami Azra, Etezadi Farhad, Safari Saeid, Sharifi Alireza, Shariat Moharari Reza
Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Anesth Pain Med. 2013 Summer;3(1):208-13. doi: 10.5812/aapm.9653. Epub 2013 Jul 1.
Colonoscopy is performed without preparing sedation in many countries. However, according to the current literature patients are more satisfied when appropriate sedation is prepared for them.
We hypothesize that propofol-ketamine may prepare more patient satisfaction compared to propofol-fentanyl combination.
Sixty adult patients older than 18 with ASA physical status of I, II or III were enrolled in the present study after providing the informed consent. They were prospectively randomized into two equal groups: 1- Group PF: was scheduled to receive IV bolus dose of fentanyl 1µg/kg and propofol 0.5mg/kg. 2- Group PK: was scheduled to receive IV bolus dose of ketamine 0.5mg/kg and propofol 0.5mg/kg. As a primary goal, patient's satisfaction was assessed by the use a Likert five-item scoring system in the recovery. Comparisons of hemodynamic parameters (mean heart rate, mean systolic blood pressure, mean diastolic blood pressure), mean Spo2 values during the procedure and side effects such as nausea, vomiting, and psychological reactions during the recovery period were our secondary goals. Level of sedation during the colonoscopy was assessed with the Observer's Assessment of Alertness/Sedation score (OAA/S).
Mean satisfaction scores in the group PK were significantly higher than the group PF (P = 0.005) while the level of sedation during the procedure was similar (P = 0.17). Hemodynamic parameters and SpO2 values were not significantly different (P > 0.05). Incidence of nausea and vomiting was the same in both groups.
IV bolus injection of propofol-ketamine can lead to more patients' satisfaction than the other protocols during colonoscopy.
在许多国家，结肠镜检查是在未准备镇静的情况下进行的。然而，根据当前文献，为患者准备适当的镇静时，患者会更满意。
我们假设与丙泊酚-芬太尼联合使用相比，丙泊酚-氯胺酮可能会使患者满意度更高。
60例年龄大于18岁、ASA身体状况为I、II或III级的成年患者在签署知情同意书后纳入本研究。他们被前瞻性地随机分为两组，每组30人：1 - PF组：计划静脉推注1μg/kg芬太尼和0.5mg/kg丙泊酚。2 - PK组：计划静脉推注0.5mg/kg氯胺酮和0.5mg/kg丙泊酚。作为主要目标，在恢复过程中使用李克特五项评分系统评估患者满意度。比较血流动力学参数（平均心率、平均收缩压、平均舒张压）、检查过程中的平均血氧饱和度值以及恢复期间的副作用，如恶心、呕吐和心理反应，为我们的次要目标。结肠镜检查期间的镇静水平采用观察者警觉/镇静评分（OAA/S）进行评估。
PK组的平均满意度评分显著高于PF组（P = 0.005），而检查过程中的镇静水平相似（P = 0.17）。血流动力学参数和血氧饱和度值无显著差异（P > 0.05）。两组恶心和呕吐的发生率相同。
结肠镜检查期间，静脉推注丙泊酚-氯胺酮比其他方案能使更多患者满意。
