Preemptive nebulized ketamine for pain control after tonsillectomy in children: randomized controlled trial

Publication date: Available online 22 May 2019Source: Brazilian Journal of Anesthesiology (English Edition)Author(s): Hala S. Abdel-Ghaffar, Amani H. Abdel-Wahab, Mohammed M. Roushdy, Amira M.M. OsmanAbstractObjectivesThe administration of ketamine as nebulized inhalation is relatively new and studies on nebulized ketamine are scarce. We aimed to investigate the analgesic efficacy of nebulized ketamine (1 and 2 mg.kg−1) administered 30 min before general anesthesia in children undergoing elective tonsillectomy in comparison with intravenous ketamine (0.5 mg.kg−1) and saline placebo.MethodsOne hundred children aged (7–12) years were randomly allocated in four groups (n = 25) receive; Saline Placebo (Group C), Intravenous Ketamine 0.5 mg.kg−1 (Group K-IV), Nebulized Ketamine 1 mg.kg−1 (Group K-N1) or 2 mg.kg−1 (Group K-N2). The primary endpoint was the total consumption of rescue analgesics in the first 24 h postoperative.ResultsThe mean time to first request for rescue analgesics was prolonged in K-N1 (400.9 ± 60.5 min, 95% CI 375.9–425.87) and K-N2 (455.5 ± 44.6 min, 95% CI 437.1–473.9) groups compared with Group K-IV (318.5 ± 86.1 min, 95% CI 282.9–354.1) and Group C (68.3 ± 21.9 min, 95% CI 59.5–77.1; p 
Source: Brazilian Journal of Anesthesiology - Category: Anesthesiology Source Type: research

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Authors: Wu X, Shan C, Peng B, Shi X, Zhang F, Cao J Abstract Comparison of desflurane and sevoflurane on the postoperative recovery quality after tonsillectomy and adenoidectomy in children was carried out. A retrospective analysis was performed on the medical records of 165 children who underwent tonsil and adenoid radiofrequency ablation under low-temperature plasma and were admitted to the Xuzhou Children's Hospital, Xuzhou Medical University from February 2014 to May 2017. In total, 79 children with sevoflurane anesthesia were in the sevoflurane group, and 86 children with desflurane anesthesia in the desflura...
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
This article is protected by copyright. All rights reserved. PMID: 31077491 [PubMed - as supplied by publisher]
Source: Paediatric Anaesthesia - Category: Anesthesiology Authors: Tags: Paediatr Anaesth Source Type: research
Conclusions: Magnesium sulfate is an important adjuvant drug in the practice of anesthesia, with several clinical effects and a low incidence of adverse events when used at recommended doses. Introduction Magnesium is the fourth most common ion in the body, and it participates in several cellular processes, including protein synthesis, neuromuscular function and stability of nucleic acid, as well as regulating other electrolytes such as calcium and sodium. Magnesium acts as a cofactor in protein synthesis, neuromuscular function and stability and the function of nucleic acids. It is a component of adenosine 5-triph...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Abstract BACKGROUND: Research has improved practitioner awareness of the impact of individual characteristics on responses to painful procedures. However, there is little data relating pre-existing temperament profiles and post-surgical/anesthesia outcomes in pediatric patients. In particular, it is not clear how best to identify which patients are at risk of poor post-surgical outcomes. AIM: In this prospective study, we examined relationships between preoperative measures of child temperament and post-operative pain/behavioral outcomes of children undergoing tonsillectomy/adenoidectomy surgeries. We sought ...
Source: Paediatric Anaesthesia - Category: Anesthesiology Authors: Tags: Paediatr Anaesth Source Type: research
This study examined the influence of child and parent anxiety on the development of younger children's postsurgical pain memories. Seventy-eight children undergoing a tonsillectomy and one of their parents participated. Parents reported on their anxiety (state and trait) before surgery, and trained researchers observationally coded children's anxiety at anaesthesia induction. Children reported on their postsurgical pain intensity and pain-related fear for 3 days after discharge. One month after surgery, children recalled their pain intensity and pain-related fear using the same scales previously administered. Results revea...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
ConclusionThe use of dexmedetomidine and local anesthetic in pediatric tonsillectomy is a safe and effective protocol that allows for the reduction of opiate use and improved post-operative pain control.Key pointsQuestion: Can the combination of dexmedetomidine and infiltration of local anesthetic reduce overall opioid use for peediatric patients undergoing tonsillectomy?Findings: In this case-control study, use of dexmedetomidine and local anesthetic injected into the tonsillar fossa led to a decrease in intraoperative opiate use by 49.6%, a decrease in intraoperative sevofluorane use by 18%, and a lower reported maximum ...
Source: American Journal of Otolaryngology - Category: Endocrinology Source Type: research
BACKGROUND Adenotonsillectomy is a frequently performed procedure in paediatric day-case surgery. Postoperative pain can be significant and standard analgesia protocols are often insufficient. OBJECTIVE Our primary objective was to investigate if infiltration of the peritonsillar space with bupivacaine would reduce the need for postoperative opioids compared with pre-emptive intravenous tramadol. DESIGN A double-blind, randomised controlled trial. SETTING Ambulatory surgical day care centre, University Hospitals of Leuven, Belgium, from January 2012 to September 2016. PATIENTS Two hundred children, between 4 ...
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Paediatric anaesthesia Source Type: research
Condition:   Post Operative Pain Interventions:   Other: Infiltration;   Other: Placebo;   Other: General anesthesia Sponsor:   Makassed General Hospital Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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