鼻内滴注咪达唑仑-氯胺酮、右美托咪定-氯胺酮、咪达唑仑-芬太尼和右美托咪定-芬太尼在患儿牙科手术中比较：随机对照试验

以下文章来源于罂粟花 ，作者anesthGH

本文由“罂粟花”授权转载  

鼻内滴注咪达唑仑-氯胺酮、右美托咪定-氯胺酮、咪达唑仑-芬太尼和右美托咪定-芬太尼在患儿牙科手术中比较：随机对照试验

贵州医科大学   麻醉与心脏电生理课题组

翻译：文春雷

编辑：柏雪

审校：曹莹

背景：为了评估各种镇静镇痛药联合使用对牙科患儿疼痛缓解和镇静的有效性，有必要对临床研究和患者预后进行充分的评估。

方法：共有128名健康、不合作的牙科患儿被随机分配通过鼻内（IN）途径接受四种药物组合中的一种：I组接受咪达唑仑-氯胺酮（MK），II组接受右美托咪定-氯胺酮（DK），III组接受咪达唑仑-芬太尼（MF），IV组接受右美托咪尼-芬太尼（DF）进行平行臂研究设计。采用不同的参数评价联合用药的疗效和安全性。

结果：DF组的镇静开始时间明显快于DK、MF和MK组（P < 0.001）。DK组和DF组的镇静深度显著高于MK组和MF组（P < 0.01）。与MK和MF联合用药相比，DK和DF产生了显著的术中和术后镇痛作用。各组合均未观察到明显的不良事件。

结论：DK组和DF组具有抗焦虑和镇痛作用，具有作为镇痛镇静剂的潜力。

原始文献来源：Abhilasha Agarwal, Afroz Alam Ansari, Rajendra Nath,et al.Comparative evaluation of intranasal midazolam-ketamine, dexmedetomidine-ketamine, midazolam-fentanyl, and dexmedetomidine-fentanyl combinations for procedural sedation and analgesia in pediatric dental patients: a randomized controlled trial.[J].J Dent Anesth Pain Med,2023；23（1）:69–81.

英文原文：

Comparative evaluation of intranasal midazolam-ketamine, dexmedetomidine-ketamine, midazolam-fentanyl, and dexmedetomidine-fentanyl combinations for procedural sedation and analgesia in pediatric dental patients: a randomized controlled

trial

Background: In order to assess the effectiveness of various analgesio-sedative combinations for pain relief and sedation in pediatric dental patients, a thorough evaluation of clinical studies and patient outcomes is necessary.

Methods: A total of 128 healthy, uncooperative pediatric dental patients were randomly allocated to receive one of the four combinations of drugs via the intranasal (IN) route: Group I received midazolam-ketamine (MK), Group II received dexmedetomidine-ketamine (DK), Group III received midazolam-fentanyl (MF), and Group IV received dexmedetomidine-fentanyl (DF) in a parallel-arm study design. The efficacy and safety of the combinations were evaluated using different parameters.

Results: The onset of sedation was significantly faster in the DF group than in the DK, MF, and MK groups (P < 0.001). The depth of sedation was significantly higher in the DK and DF groups than in the MK and MF groups (P < 0.01). DK and DF produced significant intra- and postoperative analgesia when compared with combinations of MK and MF. No significant adverse events were observed for any of the combinations.

Conclusions: The DK and DF groups showed potential as analgesio-sedatives in view of their anxiolytic and analgesic effects.

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本公众平台所刊载原创或转载内容不代表米勒之声的观点或立场。文中所涉及药物使用、疾病诊疗等内容仅供医学专业人士参考。

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编辑：MiLu.米鹭

校对：Michel.米萱 

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