Chungsamarnyart Yanipan, Pairart Jiranun, Munjupong Sithapan
Department of Anesthesiology, Phramongkutklao Hospital and Phramongkutklao Collage of Medicine, Bangkok, Thailand.
J Perioper Pract. 2022 Mar;32(3):53-58. doi: 10.1177/1750458920912636. Epub 2020 Apr 17.
Coughing and laryngospasm are undesirable consequences occurring when patients awaken from general anaesthesia. The objective of the study aimed to compare the effects of intravenous propofol and propofol with low-dose ketamine on preventing postextubation cough and laryngospasm.
In all, 120 patients scheduled surgery under general anaesthesia were randomly assigned into three groups. Patients in the control group (C-group) received intravenous 0.9% NaCl, while patients in the propofol group (P-group) received intravenous 0.25mg/kg propofol and patients in the propofol combined with ketamine group (PK-group) received intravenous 0.25mg/kg of propofol plus 0.15mg/kg of ketamine. Drugs were administered before extubation. Incidence and severity of coughing and laryngospasm were recorded by a blinded anaesthesiologist.
Subjects of the PK-group (25%) experienced significantly reduced incidence of postoperative cough than that in the P-group (55%) and C-group (72.5%) (all P < 0.05). The severity of cough in the PK-group was significantly less than that in the P-group and C-group (P = 0.039 and P < 0.001, respectively). No significant difference was found in the incidence and severity of laryngospasm between comparison groups.
Intravenous combination of propofol and low-dose ketamine significantly reduced the incidence and severity among patients awakening from general anaesthesia.
咳嗽和喉痉挛是患者从全身麻醉中苏醒时出现的不良后果。本研究的目的是比较静脉注射丙泊酚和丙泊酚联合小剂量氯胺酮对预防拔管后咳嗽和喉痉挛的效果。
总共120例计划接受全身麻醉手术的患者被随机分为三组。对照组(C组)静脉注射0.9%氯化钠,丙泊酚组(P组)静脉注射0.25mg/kg丙泊酚,丙泊酚联合氯胺酮组(PK组)静脉注射0.25mg/kg丙泊酚加0.15mg/kg氯胺酮。在拔管前给药。由一名不知情的麻醉医生记录咳嗽和喉痉挛的发生率及严重程度。
PK组患者术后咳嗽发生率(25%)显著低于P组(55%)和C组(72.5%)(均P < 0.05)。PK组咳嗽的严重程度显著低于P组和C组(分别为P = 0.039和P < 0.001)。比较组之间喉痉挛的发生率和严重程度未发现显著差异。
静脉注射丙泊酚和小剂量氯胺酮的联合用药显著降低了全身麻醉苏醒患者的发生率和严重程度。