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在收治范围病房的患者中,采用三种方法评估麻醉质量:“丙泊酚+芬太尼”对比“丙泊酚+芬太尼+利多卡因”对比“丙泊酚+芬太尼+利多卡因+氯胺酮” 。

Evaluation of anesthesia quality with three methods: "propofol + fentanyl" vs. "propofol + fentanyl + lidocaine" vs. "propofol + fentanyl + lidocaine + ketamine" in patients referred to the scoping ward.

作者信息

Edalatkhah Sepehr, Hazrati Ebrahim, Hashemi Mahmoodreza, Golaghaei Alireza, Kheradmand Behroz, Rafiei Mohamadreza

机构信息

Research Center of Surgery and Trauma, AJA University of Medical Sciences, Tehran, Iran.

出版信息

J Family Med Prim Care. 2022 Feb;11(2):672-676. doi: 10.4103/jfmpc.jfmpc_1387_21. Epub 2022 Feb 16.

Abstract

INTRODUCTION

Toleration of the complexity and pain of interventions such as endoscopy and colonoscopy is highly difficult for patients. Considering the disagreement on the method of injection of propofol, this study was performed to evaluate the quality of anesthesia using the three methods of propofol + fentanyl, propofol + fentanyl + lidocaine, and propofol + fentanyl + lidocaine + ketamine.

METHODS

This one-way blind clinical trial study included 99 patients who were admitted in three groups by block randomization method. In a group of patients that were sedated with propofol + fentanyl + lidocaine + ketamine, the dose of all drugs is reduced by half the amount of the other groups. Variables included age, sex, frequency of cough, apnea, need for jaw thrust maneuver, O saturation, duration of recovery, and procedural satisfaction. Data were analyzed using SPSS version 20.0. value of < 0.05 was considered to be significant.

RESULTS

The three groups were similar in terms of demographic characteristics. The effects of the three sedation protocols on the variables showed that patient's apnea, cough, O saturation, and also proceduralist satisfaction in the group of the patient that sedated with four drugs was significantly higher ( < 0.05) than other groups. But there was no significant difference between the three groups when comparing the recovery time and need for jaw thrust during the procedure.

CONCLUSION

The findings of the present study showed that the use of combination of "propofol + fentanyl + lidocaine + ketamine" with lower doses, significantly results in higher quality sedation compared with higher doses of "propofol + fentanyl + lidocaine" or "propofol + fentanyl" for scoping procedures.

摘要

引言

对于患者而言,耐受诸如内窥镜检查和结肠镜检查等干预措施的复杂性和痛苦是极其困难的。考虑到丙泊酚注射方法存在分歧,本研究旨在评估使用丙泊酚+芬太尼、丙泊酚+芬太尼+利多卡因以及丙泊酚+芬太尼+利多卡因+氯胺酮这三种方法的麻醉质量。

方法

这项单盲临床试验研究纳入了99例患者,通过区组随机化方法将其分为三组。在使用丙泊酚+芬太尼+利多卡因+氯胺酮进行镇静的一组患者中,所有药物的剂量比其他组减少一半。变量包括年龄、性别、咳嗽频率、呼吸暂停、下颌前推操作的需求、血氧饱和度、恢复时间以及操作满意度。使用SPSS 20.0版本对数据进行分析。P值<0.05被认为具有统计学意义。

结果

三组在人口统计学特征方面相似。三种镇静方案对变量的影响表明,使用四种药物进行镇静的患者组在呼吸暂停、咳嗽、血氧饱和度以及操作医生满意度方面均显著高于其他组(P<0.05)。但在比较三组的恢复时间以及操作过程中下颌前推的需求时,差异无统计学意义。

结论

本研究结果表明,与使用较高剂量的“丙泊酚+芬太尼+利多卡因”或“丙泊酚+芬太尼”进行检查操作相比,使用较低剂量的“丙泊酚+芬太尼+利多卡因+氯胺酮”联合用药能显著提高镇静质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e53/8963641/91dba77781cf/JFMPC-11-672-g001.jpg

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