丙泊酚与氯胺酮对接受心导管插入术的儿科患者血流动力学指标和脑氧饱和度的比较评估
Comparative Assessment of Propofol and Ketamine on Hemodynamic Indices and Cerebral Oximetry of Pediatric Patients Undergoing Cardiac Catheterization.
作者信息
Sepehri Nour Maryam, Dabbagh Ali, Fani Kamal
机构信息
Anesthesiology Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Anesthesiology Department, School of Medicine, Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
出版信息
Anesth Pain Med. 2022 Dec 7;12(6):e128763. doi: 10.5812/aapm-128763. eCollection 2022 Dec.
BACKGROUND
Propofol and ketamine are widely used in the induction and maintenance of anesthesia and sedation with different cardiovascular and respiratory effects. In cardiac anesthesia (including pediatric cardiac catheterization), due to the high risk of neurologic complications, cerebral oximetry can effectively monitor cerebral blood oxygen saturation to prevent neurological and respiratory complications.
OBJECTIVES
This study aimed to compare the effect of propofol and ketamine on hemodynamic indices and cerebral oxygenation results in children undergoing cardiac catheterization.
METHODS
This clinical trial study was performed on 48 patients who were candidates for cardiac catheterization by easy and continuous sampling. Patients were randomly divided into 2 groups: ketamine and propofol. In the ketamine group, ketamine was injected at a dose of 1 - 2 mg/kg, and in the propofol group, propofol was injected at a dose of 0.5 - 1.5 mg/kg. In both groups, incremental doses were repeated as needed. The hemodynamic indices, including blood pressure, heart rate, and peripheral SpO, were recorded. Cerebral regional oxygen saturation (RSO) was recorded using infrared spectroscopic sensors. Data were analyzed using chi-square, independent -test, paired -test, and 1-way analysis of variance (ANOVA).
RESULTS
The results showed that all demographic characteristics of patients and also the mean duration of catheterization were homogeneous between the 2 groups. Hemodynamic indices (such as systolic, diastolic, and mean arterial blood pressure) did not show a significant difference between the 2 groups; however, in the ketamine group compared to the propofol group, the heart rate was significantly higher, and mean RSO was lower (P = 0.023).
CONCLUSIONS
Propofol has fewer complications than ketamine and is a good drug for sedating children undergoing cardiac catheterization.
背景
丙泊酚和氯胺酮广泛用于麻醉诱导和维持以及镇静，具有不同的心血管和呼吸效应。在心脏麻醉（包括小儿心导管插入术）中，由于神经并发症风险高，脑氧饱和度测定可有效监测脑血氧饱和度，以预防神经和呼吸并发症。
目的
本研究旨在比较丙泊酚和氯胺酮对接受心导管插入术儿童的血流动力学指标和脑氧合结果的影响。
方法
本临床试验研究对48例拟行心导管插入术的患者进行了简便连续抽样。患者随机分为2组：氯胺酮组和丙泊酚组。氯胺酮组按1 - 2 mg/kg的剂量注射氯胺酮，丙泊酚组按0.5 - 1.5 mg/kg的剂量注射丙泊酚。两组均根据需要重复递增剂量。记录血流动力学指标，包括血压、心率和外周血氧饱和度。使用红外光谱传感器记录脑区域氧饱和度（RSO）。数据采用卡方检验、独立样本t检验、配对样本t检验和单因素方差分析（ANOVA）进行分析。
结果
结果显示，两组患者的所有人口统计学特征以及平均导管插入持续时间均无差异。血流动力学指标（如收缩压、舒张压和平均动脉压）在两组之间无显著差异；然而，与丙泊酚组相比，氯胺酮组的心率显著更高，平均RSO更低（P = 0.023）。
结论
丙泊酚的并发症比氯胺酮少，是用于为接受心导管插入术的儿童镇静的良好药物。
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