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丙泊酚与氯胺酮复合丙泊酚用于小儿经导管肺动脉瓣植入术镇静的双盲随机研究。

Propofol versus Ketofol for Sedation of Pediatric Patients Undergoing Transcatheter Pulmonary Valve Implantation: A Double-blind Randomized Study.

作者信息

Soliman Rabie, Mofeed Mohammed, Momenah Tarek

机构信息

Department of Cardiac Anesthesia, Prince Sultan Cardiac Centre, Riyadh, Saudi Arabia; Department of Anesthesia, Faculty of Medicine, Cairo University, Egypt.

Department of Cardiology, Madinah Cardiac Center, Al Madinah Al Monourah, Saudi Arabia; Department of Pediatric Cardiology, Sohag University, Egypt.

出版信息

Ann Card Anaesth. 2017 Jul-Sep;20(3):313-317. doi: 10.4103/aca.ACA_24_17.

Abstract

OBJECTIVE

The study was done to compare propofol and ketofol for sedation of pediatric patients scheduled for elective pulmonary valve implantation in a catheterization laboratory.

DESIGN

This was a double-blind randomized study.

SETTING

This study was conducted in Prince Sultan Cardiac Centre, Saudi Arabia.

PATIENTS AND METHODS

The study included 60 pediatric patients with pulmonary regurge undergoing pulmonary valve implantation.

INTERVENTION

The study included sixty patients, classified into two groups (n = 30). Group A: Propofol was administered as a bolus dose (1-2 mg/kg) and then a continuous infusion of 50-100 μg/kg/min titrated as needed. Group B: Ketofol was administered 1-2 mg/kg and then infusion of 20-60 μg/kg/min. The medication was prepared by the nursing staff and given to anesthetist blindly.

MEASUREMENTS

The monitors included heart rate, mean arterial blood pressure, respiratory rate, temperature, SPO2and PaCO2, Michigan Sedation Score, fentanyl dose, antiemetic medications, and Aldrete score.

MAIN RESULTS

The comparison of heart rate, mean arterial pressure, respiratory rate, temperature, SPO2and PaCO2, Michigan Sedation Score, and Aldrete score were insignificant (P > 0.05). The total fentanyl increased in Group A more than Group B (P = 0.045). The required antiemetic drugs increased in Group A patients more than Group B (P = 0.020). The durations of full recovery and in the postanesthesia care unit were longer in Group A than Group B (P = 0.013, P < 0.001, respectively).

CONCLUSION

The use of propofol and ketofol is safe and effective for sedation of pediatric patients undergoing pulmonary valve implantation in a catheterization laboratory. However, ketofol has many advantages more than the propofol. Ketofol has a rapid onset of sedation, a rapid recovery time, decreased incidence of nausea and vomiting and leads to rapid discharge of patients from the postanesthesia care unit.

摘要

目的

本研究旨在比较丙泊酚和酮咯酸氨丁三醇用于在导管室进行择期肺动脉瓣植入术的儿科患者镇静的效果。

设计

这是一项双盲随机研究。

地点

本研究在沙特阿拉伯苏丹王子心脏中心进行。

患者与方法

本研究纳入了60例接受肺动脉瓣植入术的肺动脉反流儿科患者。

干预措施

本研究包括60例患者,分为两组(n = 30)。A组:静脉推注丙泊酚(1 - 2mg/kg),然后根据需要以50 - 100μg/kg/min的速度持续输注。B组:静脉注射酮咯酸氨丁三醇1 - 2mg/kg,然后以20 - 60μg/kg/min的速度输注。药物由护理人员配制并盲目给予麻醉师。

测量指标

监测指标包括心率、平均动脉血压、呼吸频率、体温、SPO₂、PaCO₂、密歇根镇静评分、芬太尼剂量、止吐药物和Aldrete评分。

主要结果

心率、平均动脉压、呼吸频率、体温、SPO₂、PaCO₂、密歇根镇静评分和Aldrete评分的比较无显著差异(P > 0.05)。A组芬太尼总量增加多于B组(P = 0.045)。A组患者所需的止吐药物增加多于B组(P = 0.020)。A组完全恢复时间和在麻醉后护理单元的时间比B组长(分别为P = 0.013,P < 0.001)。

结论

丙泊酚和酮咯酸氨丁三醇用于在导管室进行肺动脉瓣植入术的儿科患者镇静是安全有效的。然而,酮咯酸氨丁三醇比丙泊酚有更多优势。酮咯酸氨丁三醇镇静起效快、恢复时间短、恶心呕吐发生率降低,并使患者能更快从麻醉后护理单元出院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7788/5535572/c4424cb99e80/ACA-20-313-g001.jpg

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