Comparison of propofol-remifentanil versus propofol-ketamine deep sedation for third molar surgery.
Anesth Prog
; 59(3): 107-17, 2012.
Article
en En
| MEDLINE
| ID: mdl-23050750
ABSTRACT
This study aimed to compare continuous intravenous infusion combinations of propofol-remifentanil and propofol-ketamine for deep sedation for surgical extraction of all 4 third molars. In a prospective, randomized, double-blinded controlled study, participants received 1 of 2 sedative combinations for deep sedation for the surgery. Both groups initially received midazolam 0.03 mg/kg for baseline sedation. The control group then received a combination of propofol-remifentanil in a ratio of 10 mg propofol to 5 µg of remifentanil per milliliter, and the experimental group received a combination of propofol-ketamine in a ratio of 10 mg of propofol to 2.5 mg of ketamine per milliliter; both were given at an initial propofol infusion rate of 100 µg/kg/min. Each group received an induction loading bolus of 500 µg/kg of the assigned propofol combination along with the appropriate continuous infusion combination . Measured outcomes included emergence and recovery times, various sedation parameters, hemodynamic and respiratory stability, patient and surgeon satisfaction, postoperative course, and associated drug costs. Thirty-seven participants were enrolled in the study. Both groups demonstrated similar sedation parameters and hemodynamic and respiratory stability; however, the ketamine group had prolonged emergence (13.6 ± 6.6 versus 7.1 ± 3.7 minutes, P = .0009) and recovery (42.9 ± 18.7 versus 24.7 ± 7.6 minutes, P = .0004) times. The prolonged recovery profile of continuously infused propofol-ketamine may limit its effectiveness as an alternative to propofol-remifentanil for deep sedation for third molar extraction and perhaps other short oral surgical procedures, especially in the ambulatory dental setting.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Piperidinas
/
Extracción Dental
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Propofol
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Anestésicos Intravenosos
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Anestésicos Combinados
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Sedación Profunda
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Hipnóticos y Sedantes
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Anestesia Dental
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Ketamina
/
Anestésicos Disociativos
Tipo de estudio:
Clinical_trials
/
Observational_studies
/
Risk_factors_studies
Idioma:
En
Revista:
Anesth Prog
Año:
2012
Tipo del documento:
Article
País de afiliación:
Estados Unidos