From the Department of Anesthesia and Intensive Care (Aloweidi, Abu-Halaweh, Abu Mahfuz, Noubani, Al Rwaidi, Bsisu); from the Division of Urology, Department of Special Surgery (Al-Edwan, AL Demour, Abufaraj), School of Medicine, The University of Jordan, Amman, Jordan; and from the Department of Urology (Abufaraj), Medical University of Vienna, Vienna, Austria.
Saudi Med J. 2021 Jun;42(6):629-635. doi: 10.15537/smj.2021.42.6.20210071.
To compare sedoanalgesia achieved using propofol-fentanyl-ketamine (PFK) combination with general anesthesia (GA) in terms of safety, hemodynamic stability, and perioperative complications.
Patients in the GA group were anesthetized using fentanyl (2 μg kg-1) and propofol (2 mg kg-1). The PFK group was anesthetized using a mixture of which each one ml contains 0.005 mg of fentanyl, 5 mg of propofol, 5 mg of ketamine, and 2 mg of lidocaine. Patients received an initial dose of 0.05 ml kg-1, followed by 0.05 mg kg-1 60 seconds later. Maintenance boluses of 0.025 ml kg-1 were administered every 3-5 minutes. Respiration occurred spontaneously through a simple face mask with 3 L min-1 O.
The GA group had 37 (37%) patients develop hypotensive episodes, compared to one (1%) episode in the PFK group (<0.001). Five (5%) patients in the PFK group had an episode of transient O desaturation, compared to one (1%) patient in the GA group (=0.212). The duration of induction and termination of anesthesia were significantly shorter in the PFK group (<0.001).
The PFK combination herein described is safe, effective, and provides intraoperative hemodynamic stability in patients with multiple comorbidities undergoing urological procedures.
比较使用丙泊酚-芬太尼-氯胺酮（PFK）联合全身麻醉（GA）在安全性、血液动力学稳定性和围手术期并发症方面的效果。
GA 组患者使用芬太尼（2μgkg-1）和丙泊酚（2mgkg-1）麻醉。PFK 组患者使用含有 0.005mg 芬太尼、5mg 丙泊酚、5mg 氯胺酮和 2mg 利多卡因的混合物麻醉。患者给予初始剂量 0.05mlkg-1，60 秒后给予 0.05mgkg-1。每 3-5 分钟给予 0.025mlkg-1 的维持剂量。通过简单的面罩以 3Lmin-1O2 自主呼吸。
GA 组有 37（37%）例患者发生低血压发作，而 PFK 组仅有 1（1%）例（<0.001）。PFK 组有 5（5%）例患者出现短暂性 O2 饱和度下降，而 GA 组有 1（1%）例（=0.212）。PFK 组的麻醉诱导和终止时间明显缩短（<0.001）。
本文描述的 PFK 联合用药在患有多种合并症的接受泌尿科手术的患者中是安全、有效且提供术中血液动力学稳定性的。
