Use of remifentanil or dexmedetomidine with ketamine for upper gastrointestinal endoscopy

Authors : Ersin KÖKSAL, Yasemin ÜSTÜN, Cengiz KAYA, Aysun Çağlar TORUN, Mehmet YILMAZ, Yunus ATALAY, Fatih ÖZKAN

Pages : 221-224

View : 38 | Download : 8

Publication Date : 2015-01-30

Article Type : Research Paper

Abstract :We compared the effects of adding remifentanil or dexmedetomidine infusions to ketamine on the quality of anaesthesia, haemodynamics and recovery in upper gastrointestinal endoscopy insert ignore into journalissuearticles values(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 insert ignore into journalissuearticles values(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 insert ignore into journalissuearticles values(RSS); of 4 was achieved. After termination of anaesthesia, the modified Aldrete score insert ignore into journalissuearticles values(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 insert ignore into journalissuearticles values(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 insert ignore into journalissuearticles values(p<0.001);. Post procedural MAS values were similar in both groups insert ignore into journalissuearticles values(p=0.716);. The time to achieve an MAS score of 9 was significantly prolonged in group D. insert ignore into journalissuearticles values(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.
Keywords : Dexmedetomidine, Endoscopy, Recovery, Remifentanil, Sedation

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