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右美托咪定联合阿芬太尼与氯胺酮联合阿芬太尼用于鼻骨骨折闭合复位患者镇静效果的比较。

Comparison of Sedation with Dexmedetomidine Alfentanil Versus Ketamine-Alfentanil in Patients Undergoing Closed Reduction of Nasal Fractures.

作者信息

Akhondzadeh Reza, Olapour Alireza, Rashidi Mahboobe, Elyasinia Fahimeh

机构信息

Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

Anesth Pain Med. 2020 Aug 25;10(4):e102946. doi: 10.5812/aapm.102946. eCollection 2020 Aug.

Abstract

OBJECTIVES

To compare the sedative effects of dexmedetomidine alfentanil versus ketamine-alfentanil in patients undergoing closed reduction of nasal fractures on the basis of intraoperative hemodynamic changes, satisfaction of patients and surgeons, and the adverse effects.

METHODS

Sixty patients with ASA class 1 or 2 were randomized to either of two groups, a dexmedetomidine alfentanil group (DA group; n = 30) or a ketamine-alfentanil group (KA group; n = 30). Hemodynamic parameters, oxygenation status, adverse events, the satisfaction of patients and surgeons, and postoperative pain scores by visual analog scale (VAS) were recorded at specific time intervals during the trial.

RESULTS

Systolic blood pressure was significantly lower in the DA group than in the KA group from T1 min to T15 min. The duration of the recovery ward stay was longer in the DA group; however, two groups were similar in terms of total anesthesia time and awakening time. Likewise, two groups were similar in terms of the patient and surgeon's satisfaction, pain scores, and the occurrence of adverse effects.

CONCLUSIONS

Both sedation methods were safely performed, and dexmedetomidine-alfentanil is as effective as ketamine-alfentanil in patients undergoing short-term operations such as nasal fracture corrections.

摘要

目的

基于术中血流动力学变化、患者及外科医生的满意度以及不良反应,比较右美托咪定联合阿芬太尼与氯胺酮联合阿芬太尼在鼻骨骨折闭合复位患者中的镇静效果。

方法

60例美国麻醉医师协会(ASA)分级为1或2级的患者被随机分为两组,右美托咪定联合阿芬太尼组(DA组;n = 30)或氯胺酮联合阿芬太尼组(KA组;n = 30)。在试验期间的特定时间间隔记录血流动力学参数、氧合状态、不良事件、患者及外科医生的满意度以及视觉模拟评分法(VAS)评估的术后疼痛评分。

结果

从T1分钟至T15分钟,DA组的收缩压显著低于KA组。DA组在恢复病房的停留时间更长;然而,两组在总麻醉时间和苏醒时间方面相似。同样,两组在患者及外科医生的满意度、疼痛评分和不良反应的发生方面相似。

结论

两种镇静方法均安全实施,且右美托咪定联合阿芬太尼在鼻骨骨折矫正等短期手术患者中与氯胺酮联合阿芬太尼效果相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89a6/7539046/976b548383d7/aapm-10-4-102946-i001.jpg

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