Damps Maria, Stołtny Ludwik, Siemek-Mitela Jadwiga, Lekstan Andrzej, Krzych Łukasz, Kucewicz-Czech Ewa
Department of Anaesthesiology and Intensive Care, Upper Silesian Child Health Centre, Katowice, Poland.
Department of Surgery, Vascular Surgery and Transplantation, Medical University of Silesia, Katowice, Poland.
Anaesthesiol Intensive Ther. 2019;51(4):262-267. doi: 10.5114/ait.2019.88185.
The search for ideal anaesthesia is still an open research issue. The aim of the study was to evaluate and compare two methods of general anaesthesia with preserved own breath - propofol with ketamine and propofol with remifentanil - in children anaesthetized for gastroscopy.
The study included 90 children enrolled for elective endoscopy of the upper gastrointestinal tract under general anaesthesia. The patients were randomized to one of two groups: Group K consisted of children anesthetized with propofol and ketamine, Group R included children anesthetized with propofol and remifentanil. Parameters monitored during anaesthesia were induction time, respiratory and circulatory parameters, adverse events, waking time and the child's condition after regaining consciousness.
The groups differed significantly in time of induction of anaesthesia (Group K 3 ± 1 min vs. Group R 4 ± 2.5 min; P < 0.001), waking time (Group R 4 ± 4.5 min vs. Group K 6 ± 5 min; P < 0.01), condition of the child after regaining consciousness (Group R 90.9% calm, Group of K 54% confused; P < 0.001) and evaluation of test conditions in the opinion of the gastroenterologist (in favour of Group K; P < 0.05).
Both methods of anaesthesia presented in the paper are safe and can be used in children to perform endoscopy. Combining propofol with ketamine allows fast induction of anaesthesia and creates very good conditions for the examination. Combining propofol with remifentanil allows fast and full return of consciousness after anaesthesia.
寻找理想的麻醉方法仍是一个开放的研究课题。本研究的目的是评估和比较两种保留自主呼吸的全身麻醉方法——丙泊酚联合氯胺酮和丙泊酚联合瑞芬太尼——用于接受胃镜检查麻醉的儿童。
本研究纳入了90名接受全身麻醉下择期上消化道内镜检查的儿童。患者被随机分为两组：K组由接受丙泊酚和氯胺酮麻醉的儿童组成，R组包括接受丙泊酚和瑞芬太尼麻醉的儿童。麻醉期间监测的参数包括诱导时间、呼吸和循环参数、不良事件、苏醒时间以及患儿苏醒后的状况。
两组在麻醉诱导时间（K组3±1分钟 vs. R组4±2.5分钟；P<0.001）、苏醒时间（R组4±4.5分钟 vs. K组6±5分钟；P<0.01）、患儿苏醒后的状况（R组90.9%平静，K组54%神志不清；P<0.001）以及胃肠病学家对检查条件的评价（有利于K组；P<0.05）方面存在显著差异。
本文介绍的两种麻醉方法都是安全的，可用于儿童进行内镜检查。丙泊酚联合氯胺酮可实现快速麻醉诱导，并为检查创造非常好的条件。丙泊酚联合瑞芬太尼可使麻醉后意识快速且完全恢复。
