Department of Anesthesia and Reanimation, Adıyaman University, Faculty of Medicine Adıyaman, Turkey.
Department of Anesthesia and Reanimation, Sular Academy Hospital, Turkey.
Niger J Clin Pract. 2022 Sep;25(9):1490-1494. doi: 10.4103/njcp.njcp_1953_21.
Percutaneous endoscopic gastrostomy (PEG) procedures are performed under sedation in critically ill patients who cannot be fed orally.
We compared the efficacy and safety of propofol-fentanyl and propofol-ketamine for deep sedation in patients undergoing PEG. Retrospective Study.
The study was conducted from 1 January 2013 to 31 December 2018 in Adıyaman University. The patients given propofol-fentanyl (0.5-1.2 mg/kg and 0.2-1 μg/kg, respectively) for sedo-analgesia were designated Group F, and those who received propofol-ketamine (0.2-0.6 mg/kg and 0.5-1 mg/kg, respectively) were placed in Group K. The demographic and hemodynamic characteristics, recovery times, perioperative complications, and need for additional doses were recorded.
Seventy-one patients who underwent PEG were analyzed. The age, sex, American Society of Anesthesiologists (ASA) score, comorbidities, duration of anesthesia, and duration of the PEG procedure were similar in the two groups. Recovery time was longer in Group K. The total propofol dose was 64 mg in Group F and 35 mg in Group K. Additional doses of propofol were administered to 12 patients in Group F, compared to none in Group K. The mean blood pressure values were higher in Group K at all-time points. The perioperative complication rate was higher in Group F. Desaturation was observed in 9 (22.5%) patients in Group F and in 3 (9.6%) patients in Group K. Hypotension was observed in 4 (10%) patients in Group F.
Propofol-ketamine should be preferred for sedoanalgesia during PEG procedures because of the lower dose of propofol, more stable blood pressure, and greater peripheral oxygen saturation. In addition, we believe ketamine-propofol is safer based on its low complication rate.
经皮内镜胃造口术（PEG）在无法口服喂养的重症患者中在镇静下进行。
我们比较了丙泊酚-芬太尼和丙泊酚-氯胺酮在接受 PEG 的患者中进行深度镇静的疗效和安全性。回顾性研究。
该研究于 2013 年 1 月 1 日至 2018 年 12 月 31 日在阿德亚曼大学进行。给予丙泊酚-芬太尼（分别为 0.5-1.2mg/kg 和 0.2-1μg/kg）进行镇静镇痛的患者被指定为 F 组，接受丙泊酚-氯胺酮（分别为 0.2-0.6mg/kg 和 0.5-1mg/kg）的患者被分为 K 组。记录人口统计学和血液动力学特征、恢复时间、围手术期并发症和需要额外剂量的情况。
分析了 71 例行 PEG 的患者。两组患者的年龄、性别、美国麻醉医师协会（ASA）评分、合并症、麻醉持续时间和 PEG 手术持续时间相似。K 组的恢复时间较长。F 组丙泊酚总剂量为 64mg，K 组为 35mg。F 组有 12 名患者需要额外给予丙泊酚，而 K 组没有。K 组各时点平均血压值较高。F 组围手术期并发症发生率较高。F 组 9 名（22.5%）患者出现血氧饱和度下降，K 组 3 名（9.6%）患者出现血氧饱和度下降。F 组 4 名（10%）患者出现低血压。
由于丙泊酚剂量较低、血压更稳定、外周血氧饱和度更高，在 PEG 手术中应优先选择丙泊酚-氯胺酮进行镇静镇痛。此外，我们认为基于较低的并发症发生率，氯胺酮-丙泊酚更安全。
