Endoskopik retrograd kolanjiyopankreatografide sedasyon: Propofol ve ketamin karışım infüzyonunun aralıklı bolus uygulamaları ile karşılaştırılması

Amaç: Endoskopik retrograd kolanjiyopankreotografide (ERCP) gerekli sedasyon düzeyini sağlamak için benzodiazepinler, propofol ve ketamin gibi sedatif ajanlar bolus veya infüzyon şeklinde uygulanabilir. Bu çalışmada propofol ve ketaminin tek enjektörde karıştırılarak infüze edildiği veya bolus şeklinde uygulandığı ERCP hastalarında ilaç tüketimini ve komplikasyonları araştırması planlanmıştır. Yöntem: Veriler, retrospektif olarak, Ocak 2007- Ocak 2008 tarihleri arasında, hasta dosyalarındaki anestezi kayıtlarından sağlanmıştır. Hastaların demografik verileri, kullanılan ilaçlar, yöntem ve işlemin süresi kaydedilmiştir. Propofol ve ketaminin aynı enjektörde infüzyon olarak verildiği hastalar Grup I; bolus uygulanan hastalar Grup II olarak ayrılmıştır. Operasyon sırasında her beş dakikada bir ölçülen kalp atım hızı, ortalama arter basıncı ve satürasyon değerleri ile kullanılan ilaç miktarları kaydedilmiştir. Ek ilaç gereksinimi ve istenmeyen etkiler değerlendirilmiştir. Bulgular: Araştırılan dönem içinde ERCP uygulanan 283 hasta dosyasından kriterlere uygun 102 hasta verisi kaydedilmiştir. Grup F de 42 hasta, Grup W de 60 hasta bulunmaktadır. Hastaların demografik verileri ve operasyon süresi benzer bulunmuştur. Ketamin miktarı gruplar arasında fark göstermezken, propofol ve midazolam dozları infüzyon grubunda anlamlı olarak düşük bulunmuştur (p

Sedation during endoscopic retrograde cholangiopancreatography: The comparison of propofol - ketamine mixture infusion with bolus administrations

Objective: Sedative agents such as benzodiazepines, propofol and ketamine may be administered as infusion or bolus doses for an adequate sedation during endoscopic retrograde cholangiopancreatography (ERCP). In this study, we aimed to compare drug consumption and adverse events in ERCP patients who received infusion of propofol-ketamine mixture or propofol and ketamine as bolus doses separately. Method: All data between January 2007 and January 2008 were collected from anaesthesia record in patients' files, retrospectively. Patients' demographic data, total sedative consumption, method and duration of procedure were recorded. Group I consisted of patients who received infusion of propofol-ketamine mixture and Group II consisted of patients who received propofol and ketamine as bolus doses separately. Heart rate, mean arterial pressure and 02 saturation measured every 5 minutes and amount of drugs used were noted. Rescue sedative requirements and adverse events were assessed. Results: Records of 102 patients suitable for assessment were enrolled to the study, out of 283 patients who underwent ERCP throughout study period. There were 42 patients in Group I and 60 patients in Group II. Demographic data and operation duration were similar between two groups. There was no difference in ketamine consumption between groups, however, propofol and midazolam consumptions were significantly less in infusion group (p<0.05). There were 6 patients who experienced tachychardia in Group II, whereas tachycardia wasn't observed in Group I (p<0.05). Conclusion: The infusion of propofol-ketamine mixture during ERCP provides less consumption of sedatives and more stable sedation state than intermittent bolus administration of the same drugs separately.

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Anestezi Dergisi-Cover
  • ISSN: 1300-0578
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1993
  • Yayıncı: Betül Kartal
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