Cavus Zuhal, Moralar Dondu Genc, Gok Ayfer Kaya, Gunaydin Ali Selman
Department of Anaesthesiology and Reanimation, University of Health Sciences Türkiye, Gaziosmanpasa Training and Research Hospital, Istanbul, Türkiye.
Sisli Etfal Hastan Tip Bul. 2024 Jun 28;58(2):189-196. doi: 10.14744/SEMB.2024.37043. eCollection 2024.
Different sedo-analgesia and monitoring methods are used during endoscopic procedures. And yet, there is no consensus on optimal sedating agents. In this study, the main aim is to compare ketamine-propofol and remifentanil propofol sedo-analgesia protocols by monitoring integrated pulmonary index (IPI).
The study population is divided into two groups: Group ketamine received 0.25 mg/kg ketamine and 0.75 mg/kg propofol at the beginning of anesthesia. 1 mcg/kg of remifentanil and 0.75 mg/kg propofol were administered to group remifentanil patients at the induction of anesthesia. Anesthesia maintenance was provided by titration of drug doses according to the Ramsey sedation scale. Measurements were taken at four different points in time: just before anesthesia was induced, five minutes after sedation was induced, ten minutes later, and five minutes after the treatment was finished.
There was no significant difference in respiratory parameters such as respiratory rate, SPO2, and EtCO measured in the T1 time period between the groups. In the T2 time period, a significant difference was found between the groups in the integrated pulmonary index (IPI), sPO2, respiratory rate, and systolic pressure parameters were found to be significantly higher in group ketamine. T3 time period results were higher in these three parameters: IPI, sPO2, and respiration rate. In the T2, T3, T4 time periods, there was a difference between the groups in the respiration count parameter and it was found to be higher in group ketamine.
Although it causes slight prolongation in recovery, ketamine is a safe and effective drug that can be used during endoscopic procedures.
在内镜检查过程中会使用不同的镇静镇痛及监测方法。然而，对于最佳镇静药物尚无共识。在本研究中，主要目的是通过监测综合肺指数（IPI）比较氯胺酮 - 丙泊酚和瑞芬太尼 - 丙泊酚镇静镇痛方案。
研究人群分为两组：氯胺酮组在麻醉开始时接受0.25mg/kg氯胺酮和0.75mg/kg丙泊酚。瑞芬太尼组患者在麻醉诱导时给予1mcg/kg瑞芬太尼和0.75mg/kg丙泊酚。根据拉姆齐镇静评分滴定药物剂量以维持麻醉。在四个不同时间点进行测量：麻醉诱导前、镇静诱导后五分钟、十分钟后以及治疗结束后五分钟。
两组在T1时间段测量的呼吸频率、SPO2和EtCO等呼吸参数无显著差异。在T2时间段，两组在综合肺指数（IPI）方面存在显著差异，氯胺酮组的sPO2、呼吸频率和收缩压参数显著更高。在这三个参数（IPI、sPO2和呼吸频率）方面，T3时间段结果更高。在T2、T3、T4时间段，两组在呼吸计数参数方面存在差异，且氯胺酮组更高。
尽管氯胺酮会导致恢复时间略有延长，但它是一种在内镜检查过程中可安全有效使用的药物。
