右美托咪定与酮洛酚在内镜逆行胰胆管造影术中的中度镇静作用对比。

Nida Aqeel, Muhammad Qamar Abbas, Syed Muhammad Abbas, Muhammad Faisal Farooq, Muhammad Siddique, Shakeel Malik
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引用次数: 0

摘要

研究目的比较右美托咪定与酮洛酚对接受内镜逆行胰胆管造影术(ERCP)的患者进行中度镇静的疗效:随机对照试验。研究地点和时间:2021年12月至2022年6月,巴基斯坦卡拉奇信德泌尿和移植研究所麻醉、SICU和疼痛管理部:纳入 62 名年龄在 20-60 岁之间、性别不限的择期 ERCP 患者。患者被随机分为右美托咪定组(2 毫升安瓿 100ug/ml 稀释在 18 毫升生理盐水中)和克托福尔组(2 毫升氯胺酮和 10 毫升 1%异丙酚稀释在 8 毫升生理盐水中)进行镇静。每组患者达到拉姆塞镇静量表(RSS)4 分和改良阿尔德雷特评分(MAS)9 分的平均时间差均为结果。此外,还记录了手术过程中的并发症和恢复情况:平均年龄(39.15±9.82)岁。男性 33 人(53.2%),女性 29 人(46.8%)。与酮洛酚相比,使用右美托咪定的患者达到 RSS 4 的平均时间明显更短,分别为 11.84 ± 1.77 分钟对 13.10 ± 1.64 分钟(P 值 0.005,95% CI -2.12 至 -0.39)。同样,使用右美托咪定治疗的患者达到 MAS 评分 9 分所需的平均时间也明显少于使用酮洛酚治疗的患者,即分别为 11.19 ± 1.72 分钟对 12.23 ± 1.84 分钟(p 值 0.026,95% CI -1.94 至 -0.13):结论:在ERCP中,右美托咪定的镇静效果优于酮洛酚,镇静更快,恢复更快:右美托咪定、酮洛芬、镇静、内镜逆行胰胆管造影。
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Dexmedetomidine versus Ketofol for Moderate Sedation in Endoscopic Retrograde Cholangiopancreatography.

Objective: To compare the efficacy of dexmedetomidine versus ketofol for moderate sedation in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP).

Study design: Randomised controlled trial. Place and Duration of the Study: Department of Anaesthesia, SICU and Pain Management, Sindh Institute of Urology and Transplantation, Karachi, Paksitan, from December 2021 to June 2022.

Methodology: Sixty-two patients aged 20-60 years of any gender scheduled for elective ERCP were included. Patients were randomly divided into Dexmedetomidine group (2ml ampule of 100ug/ml diluted in 18ml of normal saline) and Ketofol group (2ml ketamine and 10ml of propofol 1% diluted in 8ml of normal saline) for sedation. The mean difference in time to achieve Ramsay Sedation Scale (RSS) score of 4 and Modified Aldrete's Score (MAS) of 9 were noted as outcomes in each group. In addition, complications during the procedure and recovery were also noted.

Results: The mean age was 39.15 ± 9.82 years. There were 33 (53.2%) males and 29 (46.8%) females. The mean time to achieve RSS 4 was significantly lower in patients who were treated with Dexmedetomidine as compared to Ketofol, i.e., 11.84 ± 1.77 minutes vs. 13.10 ± 1.64 minutes respectively (p-value 0.005, 95% CI -2.12 to -0.39). Similarly, the mean time to achieve MAS score 9 was significantly lower in patients who were treated with Dexmedetomidine as compared to Ketofol, i.e., 11.19 ± 1.72 minutes vs. 12.23 ± 1.84 minutes, respectively (p-value 0.026, 95% CI -1.94 to -0.13).

Conclusion: Dexmedetomidine proved to be more effective than Ketofol for sedation in ERCP, achieving faster sedation and quicker recovery.

Key words: Dexmedetomidine, Ketofol, Sedation, Endoscopic Retrograde Cholangiopancreatography.

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