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氯胺酮与咪达唑仑联用对比氯胺酮与芬太尼联用在小儿体外冲击波碎石术中的应用:一项随机对照研究

Comparison of Ketamine with Midazolam versus Ketamine with Fentanyl for Pediatric Extracorporeal Shock Wave Lithotripsy Procedure: A Randomized Controlled Study.

作者信息

Akelma Hakan, Kiliç Ebru Tarikçi, Salik Fikret, Kaydu Ayhan

机构信息

Department of Anesthesiology, Diyarbakır Gazi Yasargil Research and Education Hospital, Diyarbakır, Turkey.

Department of Anesthesiology, Ümraniye Training and Research Hospital, Istanbul, Turkey.

出版信息

Anesth Essays Res. 2018 Apr-Jun;12(2):464-469. doi: 10.4103/aer.AER_44_18.

Abstract

OBJECTIVES

To compare the effects of ketamine-fentanyl (KF) and ketamine-midazolam (KM) combinations on hemodynamic parameters, recovery properties, pain, and side effects in pediatric patients undergoing extracorporeal shock wave lithotripsy (ESWL) procedure.

METHODOLOGY

In this double-blinded, randomized trial, 60 pediatric patients aged between 1 and 13 years with American Society of Anesthesiologists physical status Classes I and II, who scheduled for ESWL procedure, were included in the study. Patients were randomly divided into two groups: Group KM received 0.1 mg/kg of midazolam +1-1.5 mg/kg of ketamine and Group KF received 1 μg/kg of fentanyl +1-1.5 mg/kg of ketamine intravenously.

RESULTS

There were similar demographic properties, recovery, and discharge times between groups. No statistically significant difference was found in peripheral oxygen saturation, mean and diastolic blood pressure, Ramsey sedation scores, modified Aldrete recovery scores, side effects, and recovery times (Group KM, 16.067 ± 1.2 min; Group KF, 19.46 ± 0.86 min) between groups ( > 0.05).

CONCLUSION

KF combination offers better hemodynamic properties, less side effects with lower visual analog scores, and face, legs, activity, cry, and consolability scores than KM in the pediatric ESWL procedure.

摘要

目的

比较氯胺酮 - 芬太尼(KF)和氯胺酮 - 咪达唑仑(KM)组合对接受体外冲击波碎石术(ESWL)的儿科患者血流动力学参数、恢复特性、疼痛及副作用的影响。

方法

在这项双盲随机试验中,纳入60例年龄在1至13岁、美国麻醉医师协会身体状况分级为I级和II级且计划接受ESWL手术的儿科患者。患者被随机分为两组:KM组静脉注射0.1mg/kg咪达唑仑 + 1 - 1.5mg/kg氯胺酮;KF组静脉注射1μg/kg芬太尼 + 1 - 1.5mg/kg氯胺酮。

结果

两组间人口统计学特征、恢复及出院时间相似。两组间外周血氧饱和度、平均和舒张压、拉姆齐镇静评分、改良Aldrete恢复评分、副作用及恢复时间(KM组,16.067 ± 1.2分钟;KF组,19.46 ± 0.86分钟)差异均无统计学意义(>0.05)。

结论

在儿科ESWL手术中,与KM相比,KF组合具有更好的血流动力学特性、更少的副作用,视觉模拟评分、面部、腿部、活动、哭闹及安慰评分更低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7787/6020612/0d80eca72589/AER-12-464-g003.jpg

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