Efficacy and Tolerability of Sufentanil, Dexmedetomidine, or Ketamine Added to Propofol-based Sedation for Gastrointestinal Endoscopy in Elderly Patients: A Prospective, Randomized, Controlled Trial
Efficacy and Tolerability of Sufentanil, Dexmedetomidine, or Ketamine Added to Propofol-based Sedation for Gastrointestinal Endoscopy in Elderly Patients: A Prospective, Randomized, Controlled Trial
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DOI：
10.1016/j.clinthera.2019.06.011
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发表时间：
2019-09-01
影响因子：
3.2
通讯作者：
Liu, Youtan
中科院分区：
文献类型：
--
作者：
Yin, Shuang;Hong, Junpeng;Liu, Youtan
目的：方法：将120例拟行胃肠镜检查的老年患者随机分为丙泊酚+生理盐水组（对照组）、丙泊酚+舒芬太尼0.1 μ g/kg组、丙泊酚+右美托咪定0.4 μ g/kg组和丙泊酚+氯胺酮0.4 mg/kg组。记录平均动脉压、心率、脉搏血氧饱和度、呼气末二氧化碳分压、呼吸频率和Ramsay镇静评分。结果：在镇静过程中，丙泊酚+右美托咪定组HR的AUC最低（均P < 0.05），丙泊酚+右美托咪定组和丙泊酚+氯胺酮组的脉搏血氧饱和度AUC显著高于其他2组（均P < 0.05）。丙泊酚+右美托咪定组低血压和心动过缓发生率最高，对照组缺氧发作次数最多（均P < 0.05）。对照组丙泊酚用量最大，丙泊酚+氯胺酮组丙泊酚用量最小（均P < 0.05）。(C)2019由Elsevier Inc.出版
Purpose: To investigate the optimal agent combined with propofol for sedation in elderly patients undergoing gastrointestinal endoscopy.Methods: A total of 120 elderly patients scheduled for gastrointestinal endoscopy under propofol-based sedation were randomly allocated to receive propofol + saline (control group), propofol + sufentanil 0.1 mu g/kg, propofol + dexmedetomidine 0.4 mu g/kg, or propofol + ketamine 0.4 mg/kg. Mean arterial pressure, heart rate, pulse oximetry, pressure of endtidal carbon dioxide, respiratory rate, and Ramsay sedation scale score were recorded. Induction time, procedure time, recovery time, propofol dose, and adverse events were also recorded.Findings: During the sedation procedure, the AUC of HR was lowest in the propofol + dexmedetomidine group (all, P < 0.05), and the AUC of pulse oximetry was significantly higher in the propofol + dexmedetomidine and propofol + ketamine groups compared to the other 2 groups (both, P < 0.05). The propofol + dexmedetomidine group had the highest prevalences of hypotension and bradycardia, and the control group experienced the largest number of hypoxia episodes (all, P < 0.05). The control group consumed the highest dose of propofol, while the propofol + ketamine group needed the lowest dose (all, P < 0.05). (C) 2019 Published by Elsevier Inc.