Department of Anaesthesiology and Reanimation, University of Celal Bayar, Manisa, Turkey.
Department of Anaesthesiology and Reanimation, University of Celal Bayar, Manisa, Turkey.
J Clin Anesth. 2016 Dec;35:90-95. doi: 10.1016/j.jclinane.2016.06.025. Epub 2016 Aug 9.
To determine the effects of low-dose ketamine and propofol on cough during emergence and the recovery period when administered at emergence in children undergoing fiberoptic bronchoscopy for bronchoalveolar lavage (FOBL) with sevoflurane-remifentanil anesthesia.
Randomized, double-blind, placebo-controlled trial.
Operating room, postoperative recovery area.
Sixty-eight children aged 1 to 8 years old undergoing elective diagnostic FOBL.
After discontinuation of anesthetics at the end of FOBL, patients were randomly divided into 3 groups: in group K, children were administered 0.5 mg/kg of ketamine; in group P, 0.5 mg/kg of propofol; and in group C, 0.1 mL/kg of normal saline.
Anesthesia time, procedure time, emergence time, and recovery time were recorded. Coughing and delirium scores were recorded as the patient fully emerged from anesthesia (time 0) and 5, 10, 15, and 20 minutes later.
The percentage of children with moderate or severe cough during emergence was similar in all groups. Mean delirium scores at emergence (T0) were significantly lower in group K than those in group P and in group C (P = .0001 and P = .02). Mean delirium score at 5 minutes in group K (6 [5-10]) was significantly lower than that of group C (P = .02) and similar to that of group P. The recovery time of group K was significantly longer than that of group C and group P (P = .01 and P = .03, respectively).
Ketamine or propofol given at the end of sevoflurane-remifentanil general anesthesia in children undergoing FOBL did not decrease cough more than normal saline during the emergence period. Ketamine and propofol, compared to normal saline, had a beneficial effect on decreasing the incidence of emergence delirium. Ketamine lengthened recovery time.
确定在七氟醚-瑞芬太尼麻醉下纤维支气管镜肺泡灌洗（FOBL）中，儿童在苏醒期和恢复期使用小剂量氯胺酮和丙泊酚对咳嗽的影响。
随机、双盲、安慰剂对照试验。
手术室、术后恢复区。
68 名年龄在 1 至 8 岁之间的择期行 FOBL 的儿童。
FOBL 结束时停止麻醉后，患儿随机分为 3 组：K 组给予 0.5mg/kg 氯胺酮；P 组给予 0.5mg/kg 丙泊酚；C 组给予 0.1ml/kg 生理盐水。
记录麻醉时间、手术时间、苏醒时间和恢复时间。记录患者从麻醉中完全苏醒（时间 0）后以及 5、10、15 和 20 分钟时的咳嗽和谵妄评分。
各组患儿苏醒时出现中度或重度咳嗽的比例相似。K 组苏醒时（T0）的平均谵妄评分明显低于 P 组和 C 组（P =.0001 和 P =.02）。K 组 5 分钟时的平均谵妄评分（6 [5-10]）明显低于 C 组（P =.02），与 P 组相似。K 组的恢复时间明显长于 C 组和 P 组（P =.01 和 P =.03）。
在接受 FOBL 的儿童中，在七氟醚-瑞芬太尼全身麻醉结束时给予氯胺酮或丙泊酚并不能比生理盐水更能减少苏醒期咳嗽。与生理盐水相比，氯胺酮和丙泊酚对减少苏醒期谵妄的发生率有有益作用。氯胺酮延长了恢复时间。
