Objective: The aim of this study is to compare the sedative properties and haemodynamic and respiratory effects of dexmedetomidine and a ketamine-propofol combination (ketofol), which are expected to have minimal effects on spontaneous breathing. Methods:Sixty patients were enrolled in this prospective randomised study. Patients were divided into 2 groups according to the administration of dexmedetomidine (Group D) and ketofol (Group K). Target sedation level was determined as a Ramsay Sedation Score of 3. In Group D, 0.5 mcg kg -1 dexmedetomidine was administered via intravenous route in 10 minutes versus 0.125 mL kg -1 of a solution containing 200 mg propofol and 100 mg ketamine in Group K. Haemodynamic and respiratory effects, postoperative awakening time, analgesic properties and satisfaction levels of the patients and surgeon were assessed.Results: There was a statistically significant decrease in mean arterial pressures following drug administration compared to initial measurements in both groups. However, there was a statistically significant decrease in heart rate only in Group D. There was no significant difference between the two groups regarding respiratory rate and protection of spontaneous respiration. Although the time for Aldrete score to be 9 was 16.1 minutes for Group K, it was 24.9 minutes for Group D, and this difference was statistically significant (p<0.01). There was no significant difference between the two groups regarding adverse effects, pain scores and satisfaction levels of the patients and surgeon.Conclusion: Compared to dexmedetomidine, at similar sedation levels, sedation provided by ketofol enables satisfactory analgesia. Moreover, ketofol has a more rapid onset of action and a shorter recovery period from anaesthesia without causing significant haemodynamic or respiratory adverse effects. Bulgular:Her iki grupta da ortalama arter basınçları ilaç uygulamaları sonrası başlangıç ölçümlerine oranla anlamlı bir azalma gösterdi. Kalp atım hızı ise sadece Grup D'de anlamlı olarak azaldı. Solunum sayısı ve spontan solunumun korunması açısından iki grup arasında fark yoktu. Aldrete puanının 9 olma zamanı Grup K'da 16,1 dk iken Grup D'de 24,9 dk idi ve aralarındaki fark istatistiksel açıdan anlamlıydı (p<0,01). Yan etkiler, ağrı skorları, hasta ve cerrah memnuniyeti açısından gruplar arasında anlamlı farklılık yoktu.Sonuç: Çalışmamız sonucunda ketofol ile oluşturulan sedasyonun deksmedetomidinle karşılaştırıldığında, benzer sedasyon seviyesinde yeterli analjezi sağladığını ve hemodinamik ve solunumsal açıdan önemli bir yan etkiye yol açmaksızın daha kısa etki başlan-gıcı ve daha kısa derlenme süresine sahip olduğunu tespit ettik. 84 Giriş K atarakt cerrahisi ve vitreoretinal cerrahi en sık uygulanan oftalmik cerrahi prosedürlerdir ve genellikle sedasyon eşli-ğinde veya sedasyon olmadan lokal anestezi (LA) altında gerçekleştirilir (1, 2). Sedasyon amacıyla sıklıkla propofol, benzodiyazepinler, opioidler ve bunların kombinasyonları kullanılmaktadır. Katarakt cerrahisi çoğunlukla ileri yaş-t...
Objective: The use of intravitreal triamcinolone acetonide (IVTA) for intraocular neovascular, proliferative and edematous diseases has led to an increased incidence of corticosteroid-induced ocular hypertension. Even though largely replaced with anti-vascular endothelial growth factor (anti-VEGF) agents and slow-release dexamethasone implants, boosters are still required in nonresponsive or minimally responsive patients, in cases of tachyplaxis to these agents, or in combination therapies with anti-VEGFs. Metods: The records of 136 eyes of 124 patients who underwent 4 mg/ml IVTA treatment for macular edema of variable etiologies of diabetic macular edema, retinal vein occlusions, subretinal choroidal neovascularization, Irvine-Gass Syndrome, retinitis pigmentosa and idiopathic juxtafoveal telengiectasia in the period 2001-2006 were reviewed. Seventy-six eyes of 71 patients of which were followed for at least 3 months were included in the study. The patients were examined at the first day, second week, first month and every month after the injection. Mean intraocular pressure (IOP), IOP exceeding 21 mmHg and percentage of patients exhibiting IOP increase of 5 mmHg after IVTA injection, during the follow-up period were evaluated and compared statistically. Results: Mean age was 56.64±12.65 years and male to female ratio was 35/36. Mean follow-up time was 12.13±10.30 months. The mean IOP increased statistically (p= <0.001) during follow-up from 14.95±3.15 mmHg pre-injection level reaching to a maximum of 21.66±6.48 mmHg and decreased statistically (p= <0.001) to 15.58±4.16 mmHg at the end of the follow-up. There was no statistical difference between preinjection and post-injection IOP levels (p=0.406). The IOP levels exceeded 21 mmHg in 46.05% of the eyes. There was an increase of 5 mmHg and more above the pre-injection level in the 53.94% of the eyes. Maximum IOP levels were reached at the 2.77±3.72 month. In 24 (31.58%) eyes, topical antiglaucomatous therapy was needed and later 1 eye (4.6%) required surgical intervention and 1 eye (4.6%) required argon laser trabeculoplasty to lower the IOP. Conclusion: The most common complication following İVTA injections is rise in IOP. Most of these ocular hypertension cases are controllable by medical therapy. However, the risk of glaucoma requiring surgery or long term antiglaucomatous use validate the necessity of a meticulous patient selection and close monitorization of IOP.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.