Kardiyoversiyon Sedasyonunda Kullanılan Midazolam-Fentanil ile Midazolam-Ketamin Kombinasyonlarının Hemodinamik ve Sedatif Etkilerinin Karşılaştırılması

Abstract

Objective: The aim of the study is to compare the hemodynamic and sedation results of patients who underwent anesthesia for electrical cardioversion (EC) during a one-year period in the coronary intensive care unit, retrospectively. Methods: 60 patients who were administered ketamine or fentanyl in addition to midazolam, which was administered EC for the correction of atrial fibrillation rhythm, were evaluated in terms of the study. According to the sedation applied to the patients, they were divided into two groups as Group F (midazolam-fentanyl) and Group K (midazolam-ketamine). The hemodynamic parameters of the groups before and after the procedure and the sedation data during and after the procedure were compared. Results: The pre-intervention heart rate of the patients was found to be high in Group-F (p<0.05). There was no significant difference between the two groups in terms of systolic and diastolic blood pressures (p>0.05). While heart rate was observed to be statistically higher after the intervention in midazolam-fentanil applied patients, a statistically significant decrease was found in diastolic blood pressures (p<0.05). When Ramsay sedation scale was evaluated; There was no significant difference between the two groups at the 5th, 10th and 15th minutes (p>0.05). Conclusion: It was determined that the combination of midazolam + fentanyl or midzolam + ketamine provided adequate sedation at standard doses and had no adverse effects on hemodynamic and sedation parameters. These results made us think that both protocols can be safely applied for electrical cardioversion sedation in intensive care units.