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丙泊酚-芬太尼与丙泊酚-氯胺酮用于非手术室内镜逆行胰胆管造影术患者镇静效果的比较。

A comparison between the effects of propofol-fentanyl with propofol-ketamine for sedation in patients undergoing endoscopic retrograde cholangiopancreatography outside the operating room.

作者信息

Akhondzadeh Reza, Ghomeishi Ali, Nesioonpour Sholeh, Nourizade Sanaz

机构信息

Department of Anesthesiology, Pain Research Center, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Department of Anesthesiology, Pain Research Center, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

Biomed J. 2016 Apr;39(2):145-9. doi: 10.1016/j.bj.2015.11.002. Epub 2016 Jun 21.

Abstract

BACKGROUND

The efficient and secure techniques of anesthesia and sedation have always been needed for. One of these procedures is endoscopic retrograde cholangiopancreatography (ERCP), due to its painfulness and long duration, has high sensitivity. We compare the effects of propofol-fentanyl (PF) with propofol-ketamine (PK) to sedate patients undergoing ERCP.

METHODS

In this clinical trial, patients were divided into two groups of 49 people. A group received a pharmaceutical combination of PK, and another group received a pharmaceutical combination of PF. Vital signs of patients, Ramsey Sedation Score, and pain of patients were assessed. The total dosage of used propofol was also recorded.

RESULTS

There was no significant difference seen in the patients' hemodynamic characteristics in both groups. Pain at the end of surgery and an hour after it in the PK group was less that was not statistically significant. By Ramsey Sedation Score also significant differences were not seen between groups (p = 0.68). By using total dose of propofol used also a significant difference was not observed between the two groups (p = 0.36). Rate of apnea in PK group was 32% and in the PF group was 63%, which this difference was statistically significant (p < 0.05).

CONCLUSION

A comparison between the two drugs combination shows that although in terms of hemodynamic and sedation criteria both groups were similar, but because of the lower amount of pain and apnea in the PK group, this combination may generally in the ERCP procedure is more efficient and safer.

摘要

背景

一直以来都需要高效且安全的麻醉和镇静技术。其中一种手术是内镜逆行胰胆管造影术(ERCP),由于其具有疼痛感且持续时间长,敏感性较高。我们比较丙泊酚 - 芬太尼(PF)与丙泊酚 - 氯胺酮(PK)对接受ERCP手术患者进行镇静的效果。

方法

在这项临床试验中,患者被分为两组,每组49人。一组接受PK药物组合,另一组接受PF药物组合。评估患者的生命体征、拉姆齐镇静评分以及患者的疼痛情况。同时记录所用丙泊酚的总剂量。

结果

两组患者的血流动力学特征无显著差异。PK组手术结束时及术后一小时的疼痛较轻,但无统计学意义。根据拉姆齐镇静评分,两组之间也未观察到显著差异(p = 0.68)。使用丙泊酚的总剂量,两组之间也未观察到显著差异(p = 0.36)。PK组的呼吸暂停发生率为32%,PF组为63%,这一差异具有统计学意义(p < 0.05)。

结论

两种药物组合的比较表明,尽管在血流动力学和镇静标准方面两组相似,但由于PK组的疼痛和呼吸暂停发生率较低,这种组合在ERCP手术中总体上可能更有效且更安全。

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