- 期刊
Effects of Intravenous Ketorolac and Fentanyl Combined with Midazolam on Analgesia and Side Effects during Extracorporeal Shock Wave Lithotripsy
靜脈注射Ketorolac及Fentanyl合併Midazolam於體外震波碎石術之止痛及副作用
摘要
Background: Extracorporeal shock wave lithotripsy (ESWL) is usually carried out on ambulatory or outpatient basis, and thus an appropriate anesthesia with minimal side effects is required. This study was to compare the analgesic and side effects of intravenous ketorolac with that of intravenous fentanyl, in combination with midazolam in ESWL. Methods: Sixty patients were randomly divided into two groups; group K (n=30) received 60mg ketorolac i.v. 30min before ESWL and group F (n=30) received 100μg fentanyl i.v. 3min before ESWL. All patients received 2.5mg midazolam i.v. 3min before ESWL for intraoperative sedation. The pain intensity was evaluated by a numeric rating scale (NRS). A supplemental analgesia with intravenous fentanyl 25μg was given when inadequate analgesia occurred (NRS＞3). Oxygen supplement through a face mask was given when the SpO2 fell below 94%. Side effects (nausea, vomiting, dizziness) and the lime of discharge from post-anesthesia room (PAR) were recorded. The criterion of discharge from PAR was absence of any discomfort especially when the patient held upright. Results: There was no difference between two groups in the demographic data, number ofshock waves, duration of ESWL procedure, and fentanyl supplement. The incidence of oxygen supplement was lower in ketorolac group (1/30) compared with that of fentanyl group (20/30), P＜0.01. The frequency of dizziness was lower in ketorolac group (1/30) than that in fentanyl group (25/30), P＜0.01. Three patients in fentanyl group complained of nausea, but none did in ketorolac group. The discharge time from PAR was significantly shorter in ketorolac group (14.7±8.4min) than that in fentanyl group (49.5±14.6 min), p＜0.01. Conclusions: Both intravenous ketorolac and fentanyl in combination with midazolam could provide good anesthesia for ESWL. Howevet; ketorolac plus midazolam had less side effects and allowed shorter discharge time from PAR. We suggest that intravenous ketorolac combined with midazolam is a safe and effective anesthetic regiment for ESWL, particularly on ambulatory basis.
並列摘要
Background: Extracorporeal shock wave lithotripsy (ESWL) is usually carried out on ambulatory or outpatient basis, and thus an appropriate anesthesia with minimal side effects is required. This study was to compare the analgesic and side effects of intravenous ketorolac with that of intravenous fentanyl, in combination with midazolam in ESWL. Methods: Sixty patients were randomly divided into two groups; group K (n=30) received 60mg ketorolac i.v. 30min before ESWL and group F (n=30) received 100μg fentanyl i.v. 3min before ESWL. All patients received 2.5mg midazolam i.v. 3min before ESWL for intraoperative sedation. The pain intensity was evaluated by a numeric rating scale (NRS). A supplemental analgesia with intravenous fentanyl 25μg was given when inadequate analgesia occurred (NRS＞3). Oxygen supplement through a face mask was given when the SpO2 fell below 94%. Side effects (nausea, vomiting, dizziness) and the lime of discharge from post-anesthesia room (PAR) were recorded. The criterion of discharge from PAR was absence of any discomfort especially when the patient held upright. Results: There was no difference between two groups in the demographic data, number ofshock waves, duration of ESWL procedure, and fentanyl supplement. The incidence of oxygen supplement was lower in ketorolac group (1/30) compared with that of fentanyl group (20/30), P＜0.01. The frequency of dizziness was lower in ketorolac group (1/30) than that in fentanyl group (25/30), P＜0.01. Three patients in fentanyl group complained of nausea, but none did in ketorolac group. The discharge time from PAR was significantly shorter in ketorolac group (14.7±8.4min) than that in fentanyl group (49.5±14.6 min), p＜0.01. Conclusions: Both intravenous ketorolac and fentanyl in combination with midazolam could provide good anesthesia for ESWL. Howevet; ketorolac plus midazolam had less side effects and allowed shorter discharge time from PAR. We suggest that intravenous ketorolac combined with midazolam is a safe and effective anesthetic regiment for ESWL, particularly on ambulatory basis.
被引用紀錄
延伸閱讀
- Han, Y. Y., Lu, H. C., Tsai, H. J., Hseu, S. S., Chan, K. H., & Tsai, S. K. (2003). 以口服Morphine或Pentazocine作體外震波碎石術麻醉之止痛效果. Acta Anaesthesiologica Sinica, 41(1), 27-32. https://doi.org/10.6955/AAS.200303.0027
- Chia, Y. Y., & Liu, K. (1998). 門診體外震波碎石術中經靜脈隨機給予Tenoxicam，Fentanyl或Tramadol止痛效果的比較. Acta Anaesthesiologica Sinica, 36(1), 17-22. https://www.airitilibrary.com/Article/Detail?DocID=P20170519003-199803-201904170006-201904170006-17-22
- Yeh, F. C., Hsu, C. S., So, E. C., Chan, Y. F., Chen, J. Y., & Shieh, J. P. (1999). 低劑量Ketamine和Midazolam合併使用作爲脊髓麻醉之輔助劑. Acta Anaesthesiologica Sinica, 37(1), 15-19. https://doi.org/10.6955/AAS.199903.0015
- Lin, S. M., Chu, Y. C., Lur, J. Y., Lin, S. H., Hsiao, H. T., Lee, T. Y., & Tsai, S. K. (1998). 於成人笑氣及Fentanyl麻醉時利用預先少量給藥技術給予Mivacurium之神經肌肉作用：與Succinylcholine隨機比較的研究. Acta Anaesthesiologica Sinica, 36(2), 75-80. https://www.airitilibrary.com/Article/Detail?DocID=P20170519003-199806-201904170007-201904170007-75-80
- Wei, T. T., & Lin, C. F. (1996). 於高血壓病患持續合併注射Propofol與Alfentanil麻醉對氣管插管之影響：與Thiamylal及Nifedipine合併Thiamylal之比較. Acta Anaesthesiologica Sinica, 34(1), 9-16. https://doi.org/10.6955/AAS.199603.0009