Karasu Derya, Yilmaz Canan, Ozgunay Seyda Efsun, Karaduman Isra, Ozer Demet, Kaya Mete
Department of Anesthesiology and Reanimation, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa 16290, Turkey.
Department of Anesthesiology and Reanimation, Gaziemir Government Hospital, Izmir 35410, Turkey.
Urol J. 2018 Mar 18;15(2):21-26. doi: 10.22037/uj.v0i0.3882.
To investigate the effects of ketamine+midazolam and propofol+sevoflurane anesthesia on surgical site hemorrhage during circumcision procedures.
The boys undergoing circumcision surgery were included in the study. The patients were divided into two groups. In Group 1 (n = 50), 0.01 mg/kg midazolam and 2 mg/kg IV ketamine were administered. In Group 2 (n = 50), 1 ?g/kg fentanyl, 1 mg/kg lidocaine 2%, and 2-3 mg/kg IV propofol were administered, and patency of airway was ensured with a laryngeal mask airway. The intraoperative bleeding scale was recorded during the procedure to evaluate surgical site bleeding. Hemorrhage was checked for the first three hours using the postoperative bleeding scale to follow the amount of hemorrhage.
Intraoperative bleeding scores were significantly higher in Group 1 as compared to Group 2. However, there was no significant difference between the groups regarding frequency of postoperative hemorrhage. Themean blood pressure values measured at 5th, 10th, 15th minutes and recovery room were significantly higher in Group 1.
The intraoperative bleeding scores were significantly higher with ketamine+midazolam compared to propofol+sevoflurane. On the other hand this hemorrhage can be controlled easily with appropriate hemostasis, and the amount of blood loss was not clinically significant. We think that our study makes a positive contribution to the literature about the effects of anesthetics on the surgical site bleeding during circumcision.
ACTRN12616000189426.
探讨氯胺酮+咪达唑仑与丙泊酚+七氟醚麻醉对包皮环切术手术部位出血的影响。
纳入接受包皮环切术的男孩。患者分为两组。第1组（n = 50），静脉注射0.01 mg/kg咪达唑仑和2 mg/kg氯胺酮。第2组（n = 50），静脉注射1 μg/kg芬太尼、1 mg/kg 2%利多卡因和2 - 3 mg/kg丙泊酚，并用喉罩确保气道通畅。术中记录术中出血量表以评估手术部位出血情况。术后使用术后出血量表检查前三个小时的出血情况，以跟踪出血量。
与第2组相比，第1组术中出血评分显著更高。然而，两组术后出血频率无显著差异。第1组在第5、10、15分钟及恢复室测得的平均血压值显著更高。
与丙泊酚+七氟醚相比，氯胺酮+咪达唑仑的术中出血评分显著更高。另一方面，通过适当的止血措施可轻松控制这种出血，且失血量在临床上无显著意义。我们认为我们的研究对有关麻醉剂对包皮环切术手术部位出血影响的文献做出了积极贡献。
ACTRN12616000189426。
