Ghadami Yazdi A, Ayatollahi V, Hashemi A, Behdad Sh, Ghadami Yazdi E
Department of Anesthesia, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
Department of Pediatrics, Hematology, Oncology and Genetics Research Center, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
Iran J Ped Hematol Oncol. 2013;3(1):187-92. Epub 2013 Jan 22.
Ketamine is an anesthetic drug that is importantly analgesic without respiratory depression. Ketamine increases blood pressure and heart rate. Propofol is an anesthetic drug with good sedation, rapid recovery, but it causes respiratory depression, low heart rate and low blood pressure. Combination of Ketamine and Propofol provides sedation, analgesia and rapid recovery with hemodynamic stability and minimal respiratory depression. The aim of this study was to compare two different combinations of these two drugs to reach necessary sedation scale for the Lp or BMA in pediatric with ALL.
This randomized, double blinded study was designed to compare the quality of sedation and side effects of intravenous Ketofol on 60 patients of both gender. Patients received titrated injection of a solution containing combination of one part of Ketamine and two parts of Propofol (1:2) (group I) or one part of Ketamine and three parts of Propofol (1:3) (group II) to reach almost near 5 sedation level (using Ramsay Sedation Scale). Respiratory and hemodynamic profiles, amount of drug injected and side effects were recorded.
These drug combinations were used on 60 children with a median age of 6.2 years. In this study, recovery time and hallucination was significantly high in group I, but in both groups hemodynamic were stable, amnesia was enough, and there was no respiratory depression.
Lower doses of Ketamine in these combinations have lower psycho mimetic side effects, and shorter recovery time.
氯胺酮是一种麻醉药物，具有重要的镇痛作用且无呼吸抑制。氯胺酮会使血压和心率升高。丙泊酚是一种具有良好镇静效果、恢复迅速的麻醉药物，但它会导致呼吸抑制、心率降低和血压降低。氯胺酮和丙泊酚联合使用可提供镇静、镇痛作用，恢复迅速，血流动力学稳定且呼吸抑制最小。本研究的目的是比较这两种药物的两种不同组合，以达到小儿急性淋巴细胞白血病患者进行腰椎穿刺或骨髓活检所需的镇静程度。
本随机、双盲研究旨在比较静脉注射氯泊酚对60例男女患者的镇静质量和副作用。患者接受含一份氯胺酮和两份丙泊酚（1:2）的溶液（I组）或一份氯胺酮和三份丙泊酚（1:3）的溶液（II组）的滴定注射，以达到接近5级的镇静水平（使用 Ramsay 镇静评分）。记录呼吸和血流动力学参数、注射药物量及副作用。
这些药物组合用于60名中位年龄为6.2岁的儿童。在本研究中，I组的恢复时间和幻觉发生率显著较高，但两组的血流动力学均稳定，遗忘效果良好，且无呼吸抑制。
这些组合中较低剂量的氯胺酮具有较低的拟精神副作用和较短的恢复时间。
