Salama Atef Kamal, Ali Hassan Mohamed
Department of Anesthesia, Faculty of Medicine, Cairo University, Cairo, Egypt.
Anesth Essays Res. 2016 Jan-Apr;10(1):94-7. doi: 10.4103/0259-1162.164735.
To compare the effects of different regimens of hyoscine as antisialagogue in patients undergoing ketofol sedation for colonoscopy procedures.
In this prospective double-blind randomized controlled trial 200 American Society of Anesthesiologists I-II aged 20-60-year-old undergoing colonoscopy were randomly assigned into four equal groups, group A received 5 mg hyoscine intravenous, group B received 10 mg, group C received 20 mg intravenous, and control group (D) that was received saline. All patients were sedated using ketofol titrated to achieve Ramsey Sedation Score 4, hemodynamic variables and occurrence of increased secretions were evaluated and recorded.
Hyoscine in a dose of 10 mg was the optimum dose to achieve least salivation with the least side effect while hyoscine 5 mg was not efficient to achieve dry field or good surgical conditions. However, hyoscine 20 mg achieved dry field and fair surgical conditions in expenses of tachycardia.
Hyoscine 10 mg was the least effective dose that significantly reduced hypersalivation in patients receiving ketofol sedation for colonoscopy procedures, this dose was as effective as 20 mg in draying secretion but with significantly less tachycardia.
比较不同剂量东莨菪碱作为抗涎剂在接受氯胺酮-丙泊酚镇静下行结肠镜检查患者中的效果。
在这项前瞻性双盲随机对照试验中，200例年龄在20至60岁、美国麻醉医师协会分级为I-II级、拟行结肠镜检查的患者被随机分为四组，每组人数相等。A组静脉注射5mg东莨菪碱，B组静脉注射10mg，C组静脉注射20mg，对照组（D组）静脉注射生理盐水。所有患者均采用氯胺酮-丙泊酚进行滴定镇静，直至达到拉姆齐镇静评分4分，评估并记录血流动力学变量及分泌物增多的发生情况。
10mg剂量的东莨菪碱是实现唾液分泌最少且副作用最小的最佳剂量，而5mg的东莨菪碱在实现术野干燥或良好手术条件方面效果不佳。然而，20mg的东莨菪碱虽实现了术野干燥和较好的手术条件，但代价是出现心动过速。
10mg东莨菪碱是在接受氯胺酮-丙泊酚镇静的结肠镜检查患者中显著减少唾液分泌过多的最有效剂量，该剂量在减少分泌物方面与20mg剂量效果相当，但心动过速的发生率明显更低。
