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咪达唑仑单用与咪达唑仑联合氯胺酮用于小儿骨髓穿刺疼痛的比较效果

Comparison Effect of Midazolam Alone and Midazolam Combined with Ketamine in Bone Marrow Aspiration Pain in Children.

作者信息

Mahmoudi Nesheli H

出版信息

Iran J Ped Hematol Oncol. 2015;5(3):131-7. Epub 2015 Jul 20.

Abstract

BACKGROUND

This study aimed to compare sedative and analgesic effects of oral Midazolam and Ketamine on Bone Marrow aspiration (BMA) and Lumbar Puncture (LP).

MATERIAL AND METHODS

This study was a randomized clinical trial and was performed in Amirkola Hospital in north of Iran, Babol during 2011 and 2012 .The study population consisted of 40 patients who underwent the first time of diagnostic BMA for any reason, patients were divided randomly in two groups: Oral Midazolam and combined Oral Midazolam and Ketamine. Each group consisted of patients with age of 3-7 years and over 7 years .Two methods of pain status and soothing were evaluated through CAMFORT scale checklist based on MAGNUSON National Institutes of Health Medical Center. Statistical analyses were done by Spss v.19.

RESULTS

In our study, 17(42.5%) and 23(57.5%) were female and male, respectively. 28(70%) patients were aged between 3 and 7 years and 13(30%) older than 7 years. The obtained findings revealed that the difference between Midazolam sedation and combination of Midazolam and Ketamine sedation was significant (P= 0.00). The sedation in older patients was more than young patients in combination of Midazolam and Ketamine group. (P= 0.22).

CONCLUSION

These findings showed that Ketamine and Midazolam combination had more efficacy than Midazolam alone for decreasing pain and sedation.

摘要

背景

本研究旨在比较口服咪达唑仑和氯胺酮对骨髓穿刺(BMA)和腰椎穿刺(LP)的镇静和镇痛效果。

材料与方法

本研究为一项随机临床试验,于2011年至2012年在伊朗北部巴博勒的阿米科拉医院进行。研究对象为40例因任何原因首次接受诊断性BMA的患者,患者被随机分为两组:口服咪达唑仑组和口服咪达唑仑与氯胺酮联合组。每组包括3至7岁和7岁以上的患者。基于美国国立卫生研究院马格努森医学中心的CAMFORT量表清单评估了两种疼痛状态和安抚方法。采用Spss v.19进行统计分析。

结果

在我们的研究中,女性17例(42.5%),男性23例(57.5%)。28例(70%)患者年龄在3至7岁之间,13例(30%)年龄大于7岁。所得结果显示,咪达唑仑镇静与咪达唑仑和氯胺酮联合镇静之间的差异具有统计学意义(P = 0.00)。在咪达唑仑和氯胺酮联合组中,老年患者的镇静效果优于年轻患者(P = 0.22)。

结论

这些结果表明,氯胺酮和咪达唑仑联合使用在减轻疼痛和镇静方面比单独使用咪达唑仑更有效。

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