Sruthi S, Mandal Banashree, Rohit Manoj K, Puri Goverdhan Datt
Department of Anaesthesia and Intensive Care, PGIMER, Chandigarh, India.
Department of Cardiology, PGIMER, Chandigarh, India.
Ann Card Anaesth. 2018 Apr-Jun;21(2):143-150. doi: 10.4103/aca.ACA_171_17.
Moderate sedation is required for out-patient transesophageal echocardiography (TEE). Our objective was to compare the effect of Ketofol and dexmedetomidine for outpatient procedural sedation in diagnostic TEE with a hypothesis that Ketofol would be as effective as dexmedetomidine. Patients and.
Fifty adult patients of age group 18-60 years with atrial septal defect, rheumatic valvular heart disease undergoing diagnostic TEE in the outpatient echocardiography laboratory were randomized into two groups, group D and group KF. GROUP D: Dexmedetomidine infusion -200 μg in 20 ml normal saline. GROUP KF: Ketofol infusion: (ketamine: propofol, 1mg: 3 mg in 20 ml syringe). Loading dose of drug at 1ml/kg/hour IV till Ramsay sedation score (RSS) ≥ 3 achieved followed by maintenance infusion at 0.05 ml/kg/hour till end of procedure.
The primary outcome - time to achieve Ramsay sedation score ≥ 3 was significantly lesser with Ketofol as compared to Dexmedetomidine 260[69] seconds vs 460 [137], (p value<0.05).
In out-patient setting, ketofol is favourable over dexmedetomidine for sedation regimen for diagnostic TEE as lesser time is taken to achieve optimal sedation with lesser hemodynamic perturbations, post procedure complications and better cardiologist satisfaction.
门诊经食管超声心动图（TEE）检查需要适度镇静。我们的目的是比较氯胺酮复合丙泊酚（Ketofol）和右美托咪定用于门诊诊断性TEE检查时程序镇静的效果，假设Ketofol与右美托咪定效果相同。患者及……
50例年龄在18 - 60岁、患有房间隔缺损、风湿性瓣膜性心脏病且在门诊超声心动图实验室接受诊断性TEE检查的成年患者被随机分为两组，D组和KF组。D组：静脉输注右美托咪定200μg于20ml生理盐水中。KF组：静脉输注Ketofol（氯胺酮：丙泊酚，1mg:3mg于20ml注射器中）。以1ml/kg/小时的速度静脉推注药物直至达到Ramsay镇静评分（RSS）≥3，随后以0.05ml/kg/小时的速度维持输注直至检查结束。
与右美托咪定相比，Ketofol达到Ramsay镇静评分≥3的主要结局时间显著更短，分别为260[69]秒和460[137]秒，（p值<0.05）。
在门诊环境中，对于诊断性TEE检查的镇静方案，Ketofol优于右美托咪定，因为达到最佳镇静所需时间更短，血流动力学干扰更小，术后并发症更少，且心脏病专家满意度更高。
