ผลต่อระบบไหลเวียนเลือดและผลอันไม่พึงประสงค์จากยา propofol/ketamine เปรียบเทียบกับpropolfol/fentanyl ในผู้ป่วยที่มาขูดมดลูก
Ang-kanarwiriyarak S, Chongsuvivatwong V, Phadungchaichote N*, ลักษมี ชาญเวชช์
Department of Anesthesiology, Faculty of medicine, Prince of Songkhla University,Songkha 90110
บทคัดย่อ
A randomized double-blind study was conducted to compare hemodynamic and adverse effects of propofol/fentanyl (P/F) and propofol/ketamine (P/K) for total intravenous anesthesia (TIVA) in 112 ASA class 1, 2 patients scheduled for uterine curettage in Songkhlanagarind Hospital. After patients were given 2 mg/kg propofol during induction, the anesthesia was maintained with 8 mg/kg/hr propofol. The P/F group received fentanyl 1 mg/kg and the P/K group received ketamine 0.5 ma/kg for analgesia. In the P/F group, 55.4% had hypotension and 30.6% had bradycardia whereas 25% (p=0.001) and 10.7% (p=0.008) in the P/K group had hypotension and bradycardia respectively. The incidence of apnea and oxygen desaturation in the P/F were 19.6% and 42.9% respectively while in the P/K group, there were 3.6% (p=0.008) and 10.7% (p<0.0001) respectively. The P/F group had shorter time to awakening than the P/K group mean (SD); 4.86 (3.33) min vs 7.79 (5.7) min (p=0.002). there were no difference in other adverse effects, pain score, and analgesic requirement. In addition, no emergence phenomenon in the P/K group was detected.
ที่มา
วิสัญญีสาร ปี 2545, October-December ปีที่: 28 ฉบับที่ 4 หน้า 140-146
คำสำคัญ
adverse effect, hemodynamic minor gynecologic patients, propofol/fentanyl, propofol/ketamine, randomized double-blind study