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包皮环切术中的氯胺酮-丙泊酚镇静

Ketamine-propofol sedation in circumcision.

作者信息

Gulec Handan, Sahin Saziye, Ozayar Esra, Degerli Semih, Bercin Fatma, Ozdemir Osman

机构信息

Kecioren Training Hospital, Ankara, Turkey.

Kecioren Training Hospital, Ankara, Turkey.

出版信息

Braz J Anesthesiol. 2015 Sep-Oct;65(5):367-70. doi: 10.1016/j.bjane.2014.03.002. Epub 2014 Mar 31.

Abstract

BACKGROUND AND OBJECTIVE

To compare the therapeutic effects of ketamine alone or ketamine plus propofol on analgesia, sedation, recovery time, side effects in premedicated children with midazolam-ketamine-atropin who are prepared circumcision operation.

METHODS

60 American Society of Anaesthesiologists physical status I-II children, aged between 3 and 9 years, undergoing circumcision operations under sedation were recruited according to a randomize and double-blind institutional review board-approved protocol. Patients were randomized into two groups via sealed envelope assignment. Both groups were administered a mixture of midazolam 0.05mg/kg+ketamine 3mg/kg+atropine 0.02mg/kg intramuscularly in the presence of parents in the pre-operative holding area. Patients were induced with propofol-ketamine in Group I or ketamine alone in Group II.

RESULTS

In the between-group comparisons, age, weight, initial systolic blood pressure, a difference in terms of the initial pulse rate was observed (p>0.050). Initial diastolic blood pressure and subsequent serial measurements of 5, 10, 15, 20thmin, systolic blood pressure, diastolic blood pressure and pulse rate in ketamine group were significantly higher (p<0.050).

CONCLUSION

Propofol-ketamine (Ketofol) provided better sedation quality and hemodynamy than ketamine alone in pediatric circumcision operations. We did not observe significant complications during sedation in these two groups. Therefore, ketofol appears to be an effective and safe sedation method for circumcision operation.

摘要

背景与目的

比较氯胺酮单独使用或氯胺酮联合丙泊酚对接受咪达唑仑 - 氯胺酮 - 阿托品预处理的准备行包皮环切术儿童的镇痛、镇静、恢复时间及副作用的治疗效果。

方法

根据机构审查委员会批准的随机双盲方案,招募60例年龄在3至9岁、美国麻醉医师协会身体状况分级为I - II级、在镇静下接受包皮环切术的儿童。通过密封信封分配将患者随机分为两组。两组患者均在术前等候区当着家长的面肌内注射咪达唑仑0.05mg/kg + 氯胺酮3mg/kg + 阿托品0.02mg/kg的混合剂。I组患者用丙泊酚 - 氯胺酮诱导,II组仅用氯胺酮诱导。

结果

组间比较时,观察到年龄、体重、初始收缩压方面无差异,初始脉搏率有差异(p>0.050)。氯胺酮组的初始舒张压以及随后第5、10、15、20分钟的收缩压、舒张压和脉搏率的系列测量值显著更高(p<0.050)。

结论

在小儿包皮环切术中,丙泊酚 - 氯胺酮(凯托酚)比单独使用氯胺酮提供更好的镇静质量和血流动力学。在这两组镇静过程中我们未观察到明显并发症。因此,凯托酚似乎是一种用于包皮环切术的有效且安全的镇静方法。

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