Acetaminophen or ketorolac for post myringotomy pain in children? A prospective, double‐blinded comparison

Bean-Lijewski, Jolene D.; Stinson, J.

doi:10.1046/j.1460-9592.1997.d01-47.x

Cited by 33 publications

(17 citation statements)

References 5 publications

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“…It is unlikely that the few extra minutes of sleep in the patients who received midazolam before their sevoflurane allowed significant absorption of acetaminophen. Even if that were so, the benefits of such low‐potency analgesics are difficult to demonstrate in myringotomy patients (18, 19). All things considered, the agitation seen after sevoflurane was not due to pain.…”

Section: Discussionmentioning

confidence: 99%

Effects of sevoflurane anaesthesia on recovery in children: a comparison with halothane

Lapin

Auden

Goldsmith

et al. 1999

Pediatric Anesthesia

181

127

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We prospectively studied one hundred ASA physical status I-II children, ages six months to six years, undergoing myringotomy surgery. Children were randomly assigned to one of four anaesthetic groups receiving either halothane or sevoflurane for anaesthesia and oral midazolam premedication or no premedication. We found that children anaesthetized with sevoflurane had significantly faster recovery times and discharge home times than those who received halothane. Patients given oral midazolam premedication had significantly longer recovery times, but no delay in discharge home compared with those not premedicated. However, children anaesthetized with sevoflurane and no premedication had an unacceptably high incidence (67%) of postoperative agitation. The use of oral midazolam preoperatively did decrease the amount of postoperative agitation seen with sevoflurane. We conclude that although sevoflurane does shorten recovery times, the degree of associated postoperative agitation makes it unacceptable as a sole anaesthetic for myringotomy surgery.

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Section: Discussionmentioning

confidence: 99%

Effects of sevoflurane anaesthesia on recovery in children: a comparison with halothane

Lapin

Auden

Goldsmith

et al. 1999

Pediatric Anesthesia

181

127

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“…Oral paracetamol, ibuprofen or diclofenac should be administered 30 minutes prior to the procedure where possible 31. Ketorolac is an alternative nonsteroidal analgesic and has been shown to provide superior immediate postoperative analgesia when compared with paracetamol alone; however, up to 30% of these patients may still require additional analgesia in the immediate postoperative period 31,32. Combinations of paracetamol and a nonsteroidal or intranasal fentanyl have also been studied but in combination do not provide any additional analgesic benefit in the immediate postoperative period 33.…”

Section: Perioperative Carementioning

confidence: 99%

Ambulatory anesthetic care in children undergoing myringotomy and tube placement: current perspectives

Robinson

Engelhardt

2017

LRA

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PurposeMyringotomy and tube placement is one of the most frequently performed ear, nose and throat (ENT) surgeries in the pediatric population. Effective anesthetic management is vital to ensuring successful ambulatory care and ensuring child and parental satisfaction.Recent findingsThis review summarizes recently published studies about the long-term effects of general anesthesia in young children, novel approaches to preoperative fasting and simplified approaches to the assessment and management of emergence delirium (ED) and emergence agitation (EA). New developments in perioperative ambulatory care, including management of comorbidities and day care unit logistics, are discussed.SummaryLong-term follow-up of children exposed to general anesthesia before the age of 4 years has limited impact on academic achievement or cognitive performance and should not delay the treatment of common ENT pathology, which can impair speech and language development. A more liberal approach to fasting, employing a 6–4–0 regime allowing children fluids up until theater, may become an accepted practice in future. ED and EA should be discriminated from pain in recovery and, where the child is at risk of harm, should be treated promptly. Postoperative pain at home remains problematic in ambulatory surgery and better parental education is needed. Effective ambulatory care ultimately requires a well-coordinated team approach from effective preassessment to postoperative follow-up.

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“…Ketorolac 1 mg·kg −1 provides minor improvements in analgesia when compared with low doses of paracetamol, 10 mg·kg −1 (3,8); paracetamol 10 mg·kg −1 + codeine 1 mg·kg −1 (8); and paracetamol 15 mg·kg −1 (but only first 10 min there was no difference at 20 min) (4).…”

Section: 2 Ent Surgerymentioning

confidence: 99%

Postoperative pain

Howard¹,

Carter²,

Curry³

et al. 2008

Pediatric Anesthesia

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Concentrations associated with arousal in children are analogous to adults. The ability to recall and remember occurs at similar concentrations to those associated with arousal. A concentration of 1 mg.l(-1) was associated with a sedation level of three or less (arouses to consciousness with moderate tactile or loud verbal stimulus) in 95% of children while 1.5 mg.l(-1) was associated with a sedation level of two or less (rouses slowly to consciousness with sustained painful stimulus) in 95% of children. These concentrations can be attained for 3-4 min after 1 mg.kg(-1) and 1.5 mg.kg(-1) ketamine IV bolus, respectively. The mean arousal time can be anticipated at approximately 10 min (1 mg.kg(-1)) and 15 min (1.5 mg.kg(-1)).

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Acetaminophen or ketorolac for post myringotomy pain in children? A prospective, double‐blinded comparison

Cited by 33 publications

References 5 publications

Effects of sevoflurane anaesthesia on recovery in children: a comparison with halothane

Effects of sevoflurane anaesthesia on recovery in children: a comparison with halothane

Ambulatory anesthetic care in children undergoing myringotomy and tube placement: current perspectives

Postoperative pain

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