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Use of remifentanil or dexmedetomidine with ketamine for upper gastrointestinal endoscopy

Yıl 2014, Cilt: 31 Sayı: 4, 221 - 224, 30.01.2015

Öz

We compared the effects of adding remifentanil or dexmedetomidine infusions to ketamine on the quality of anaesthesia, haemodynamics and recovery in upper gastrointestinal endoscopy (UGE). The study included 80 patients. The patients were randomised into two groups. Group R received a remifentanil infusion at a loading dose of 0.5 μg/kg/10 min, followed by 0.1 μg/kg/min of remifentanil plus 1 mg/kg of ketamine. Group D received a dexmedetomidine infusion at a loading dose of 0.5 μg/kg/10 min, followed by 0.2 μg/kg/min of dexmedetomidine plus 1 mg/kg of ketamine. In both groups, propofol (0.5-1 mg/kg) was added to the anaesthesia regimen if adequate sedation could not be achieved. The procedure commenced when a Ramsay sedation score (RSS) of 4 was achieved. After termination of anaesthesia, the modified Aldrete score (MAS) was used as the criterion for the discharge of patients from the postanaesthesia care unit. After a MAS of 9 was reached, the patient was discharged from the postanaesthesia care unit. Demographic and haemodynamic data were similar in both groups. The requirement for propofol was significantly higher in group D (p=0.002). In group R, the RSS was relatively higher in the first minute of UGE but lower at 15 min. The time to reach an RSS of 4 was significantly shorter in group R (p<0.001). Post procedural MAS values were similar in both groups (p=0.716). The time to achieve an MAS score of 9 was significantly prolonged in group D. (p=0.030). The procedural times were comparable in both groups. In conclusion; remifentanil infusion added to ketamine provides faster, more efficient sedoanalgesia and relatively more rapid recovery when compared with a dexmedetomidine infusion.

Kaynakça

  • Aldrete, J.A., 1995. The post-anesthesia recovery score revisited. J. Clin. Anesth. 7, 89-91.
  • American Society of Anesthesiologists Task Force on Preanesthesia Evaluation, 2002. Practice advisory for preanesthesia evaluation Anesthesiology. 96, 485-496.
  • Chen, K.Z., Ye, M., Hu, C.B., Shen, X., 2014. Dexmedetomidine vs remifentanil intravenous anaesthesia and spontaneous ventilation for airway foreign body removal in children. Br. J. Anaesth. 112, 892-897.
  • Demiraran, Y., Korkut, E., Tamer, A,. Yorulmaz, I., Kocaman, B., Sezen, G., Akcan, Y., 2007. The comparison of dexmedetomidine and midazolam used for sedation of patients during upper endoscopy: A prospective, randomized study. Can. J. Gastroenterol. 21, 25-29.
  • Devabhakthuni, S., 2013. Efficacy and safety of remifentanil as an alternative labor analgesic. Clin. Med. Insights. Womens Health. 6, 37-49.
  • Esen, E., Ustün, Y., Balcioğlu, Y.O., Alparslan, Z.N., 2005. Evaluation of patient-controlled remifentanil application in third molar surgery. J. Oral. Maxillofac. Surg. 63, 457-463. Koksal et al.
Yıl 2014, Cilt: 31 Sayı: 4, 221 - 224, 30.01.2015

Öz

Kaynakça

  • Aldrete, J.A., 1995. The post-anesthesia recovery score revisited. J. Clin. Anesth. 7, 89-91.
  • American Society of Anesthesiologists Task Force on Preanesthesia Evaluation, 2002. Practice advisory for preanesthesia evaluation Anesthesiology. 96, 485-496.
  • Chen, K.Z., Ye, M., Hu, C.B., Shen, X., 2014. Dexmedetomidine vs remifentanil intravenous anaesthesia and spontaneous ventilation for airway foreign body removal in children. Br. J. Anaesth. 112, 892-897.
  • Demiraran, Y., Korkut, E., Tamer, A,. Yorulmaz, I., Kocaman, B., Sezen, G., Akcan, Y., 2007. The comparison of dexmedetomidine and midazolam used for sedation of patients during upper endoscopy: A prospective, randomized study. Can. J. Gastroenterol. 21, 25-29.
  • Devabhakthuni, S., 2013. Efficacy and safety of remifentanil as an alternative labor analgesic. Clin. Med. Insights. Womens Health. 6, 37-49.
  • Esen, E., Ustün, Y., Balcioğlu, Y.O., Alparslan, Z.N., 2005. Evaluation of patient-controlled remifentanil application in third molar surgery. J. Oral. Maxillofac. Surg. 63, 457-463. Koksal et al.
Toplam 6 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Surgery Medical Sciences
Yazarlar

Ersin Köksal

Yasemin Üstün

Cengiz Kaya

Aysun Çağlar Torun

Mehmet Yılmaz Bu kişi benim

Yunus Atalay Bu kişi benim

Fatih Özkan

Yayımlanma Tarihi 30 Ocak 2015
Gönderilme Tarihi 19 Ekim 2014
Yayımlandığı Sayı Yıl 2014 Cilt: 31 Sayı: 4

Kaynak Göster

APA Köksal, E., Üstün, Y., Kaya, C., Çağlar Torun, A., vd. (2015). Use of remifentanil or dexmedetomidine with ketamine for upper gastrointestinal endoscopy. Journal of Experimental and Clinical Medicine, 31(4), 221-224.
AMA Köksal E, Üstün Y, Kaya C, Çağlar Torun A, Yılmaz M, Atalay Y, Özkan F. Use of remifentanil or dexmedetomidine with ketamine for upper gastrointestinal endoscopy. J. Exp. Clin. Med. Şubat 2015;31(4):221-224.
Chicago Köksal, Ersin, Yasemin Üstün, Cengiz Kaya, Aysun Çağlar Torun, Mehmet Yılmaz, Yunus Atalay, ve Fatih Özkan. “Use of Remifentanil or Dexmedetomidine With Ketamine for Upper Gastrointestinal Endoscopy”. Journal of Experimental and Clinical Medicine 31, sy. 4 (Şubat 2015): 221-24.
EndNote Köksal E, Üstün Y, Kaya C, Çağlar Torun A, Yılmaz M, Atalay Y, Özkan F (01 Şubat 2015) Use of remifentanil or dexmedetomidine with ketamine for upper gastrointestinal endoscopy. Journal of Experimental and Clinical Medicine 31 4 221–224.
IEEE E. Köksal, “Use of remifentanil or dexmedetomidine with ketamine for upper gastrointestinal endoscopy”, J. Exp. Clin. Med., c. 31, sy. 4, ss. 221–224, 2015.
ISNAD Köksal, Ersin vd. “Use of Remifentanil or Dexmedetomidine With Ketamine for Upper Gastrointestinal Endoscopy”. Journal of Experimental and Clinical Medicine 31/4 (Şubat 2015), 221-224.
JAMA Köksal E, Üstün Y, Kaya C, Çağlar Torun A, Yılmaz M, Atalay Y, Özkan F. Use of remifentanil or dexmedetomidine with ketamine for upper gastrointestinal endoscopy. J. Exp. Clin. Med. 2015;31:221–224.
MLA Köksal, Ersin vd. “Use of Remifentanil or Dexmedetomidine With Ketamine for Upper Gastrointestinal Endoscopy”. Journal of Experimental and Clinical Medicine, c. 31, sy. 4, 2015, ss. 221-4.
Vancouver Köksal E, Üstün Y, Kaya C, Çağlar Torun A, Yılmaz M, Atalay Y, Özkan F. Use of remifentanil or dexmedetomidine with ketamine for upper gastrointestinal endoscopy. J. Exp. Clin. Med. 2015;31(4):221-4.