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在病态肥胖患者的上消化道内镜检查中,阿芬太尼与氯胺酮联合丙泊酚用于镇静的比较。

Alfentanil versus ketamine combined with propofol for sedation during upper gastrointestinal system endoscopy in morbidly obese patients.

作者信息

Kılıc Ertugrul, Demiriz Barış, Isıkay Nurgül, Yıldırım Abdullah E, Can Selman, Basmacı Cem

机构信息

Department of Anesthesiology, Şehitkamil State Hospital, Gaziantep, Turkey. E-mail.

出版信息

Saudi Med J. 2016 Nov;37(11):1191-1195. doi: 10.15537/smj.2016.11.14557.

Abstract

OBJECTIVES

To observe the effects of both propofol/alfentanil and propofol/ketamine on sedation during upper gastrointestinal system endoscopy in morbidly obese patients (UGSEMOP).

METHODS

In a prospective, double-blinded, randomized clinical study, 52 patients scheduled for UGSEMOP were assigned to either group A (n=26; 10 µg/kg intravenous [IV] alfentanil) or group K (n=26; 0.5 mg/kg IV ketamine). Each patient was administered 0.7 mg/kg propofol for induction. If it was needed, the patients were administered an additional dose of IV propofol. This study was performed in Sehitkamil State Hospital, Gaziantep, Turkey, between January 2014-2015. Total propofol consumption, time to achieve Modified Aldrete Scores (MAS) of 5 and 10 following the procedure, physician and patient satisfaction scores, and instances of side effects, such as bradycardia and hypotension were recorded. Results: Time to onset of sedation and duration of sedation were both significantly shorter in group A. Patients in group A also required less time to achieve an MAS of 5. Total propofol consumption was significantly lower in group A.

CONCLUSION

Both propofol/alfentanil and propofol/ketamine combinations provided appropriate hypnosis and analgesia during UGSEMOP. However, propofol consumption was significantly higher using the propofol/ketamine combination.

摘要

目的

观察丙泊酚/阿芬太尼和丙泊酚/氯胺酮对病态肥胖患者上消化道系统内镜检查(UGSEMOP)期间镇静的效果。

方法

在一项前瞻性、双盲、随机临床研究中,52例计划进行UGSEMOP的患者被分为A组(n = 26;静脉注射[IV]阿芬太尼10μg/kg)或K组(n = 26;静脉注射氯胺酮0.5mg/kg)。每位患者静脉注射0.7mg/kg丙泊酚进行诱导。如有需要,给患者追加静脉注射丙泊酚剂量。本研究于2014年1月至2015年在土耳其加济安泰普的谢希卡米尔州立医院进行。记录丙泊酚总消耗量、术后达到改良Aldrete评分(MAS)5分和10分的时间、医生和患者满意度评分以及心动过缓和低血压等副作用情况。结果:A组镇静起效时间和镇静持续时间均显著缩短。A组患者达到MAS 5分所需时间也更短。A组丙泊酚总消耗量显著更低。

结论

丙泊酚/阿芬太尼和丙泊酚/氯胺酮组合在UGSEMOP期间均提供了适当的催眠和镇痛效果。然而,使用丙泊酚/氯胺酮组合时丙泊酚消耗量显著更高。

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