Complications of sevoflurane–fentanyl versus midazolam–fentanyl anesthesia in pediatric cleft lip and palate surgery: a randomized comparison study

Milić, Morena; Goranović, Tatjana; Knežević, Predrag

doi:10.1016/j.ijom.2009.09.007

Cited by 17 publications

(6 citation statements)

References 20 publications

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“…The incidence was much higher than that of the early ones. 29 Because it was quite different to define the degree of secondary deformity and voice disorders, the percentage of long-term complications may be markedly variable in different patients. In this group, 66 of the patients with cleft palate experienced velopharyngeal incompetence, thus leading to voice disorders in 58 patients.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Complications in Primary Cleft Lips and Palates Surgery

Zhang¹,

Fang²,

Zhang³

et al. 2014

Journal of Craniofacial Surgery

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Section: Discussionmentioning

confidence: 99%

Analysis of Complications in Primary Cleft Lips and Palates Surgery

Zhang¹,

Fang²,

Zhang³

et al. 2014

Journal of Craniofacial Surgery

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“…Cleft palate repair in children is a common pathological craniofacial abnormality condition that characterized by critical postoperative pain [1,2]. This surgery needs general anesthesia and effective pain management during and after surgery in children as it can result in delirium (emergence agitation) [1,3].…”

Section: Introductionmentioning

confidence: 99%

Effect of intravenous magnesium sulphate or dexamethasone as adjuvants to sevoflurane anesthesia to prevent delirium during primary cleft palate repair, controlled randomized blind study

Elsonbaty

lsonbaty

2017

Egyptian Journal of Anaesthesia

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Background: Emergence delirium (ED) is a frequent postoperative complication in young children undergoing cleft palate repair and it may be exacerbated by sevoflurane anesthesia. Objective: This study was undertaken to study the effect of magnesium sulphate or dexamethasone as adjuvants to sevoflurane in decreasing the delirium after primary cleft palate repair. Patients and methods: 90 patients undergoing primary cleft palate repair were randomized into 3 groups equally. Controlled group (group C): continue without any addition, Magnesium group (group M): 30 mg/kg loading dose on 10 min then 10 mg/kg every one hour though the operation and Dexamethasone group (group D): 0.15 mg/kg single dose after induction. During the study period, heart rate, mean arterial blood pressure, postoperative delirium, blood glucose level and nausea were recorded for 120 min. Results: The heart rate and blood pressure were significantly decreased in group M and group D, than the control group. Significant lower postoperative delirium and nausea in group D and M in comparison with control group although D group had the best effects. Conclusion: Co-administration of intravenous magnesium sulphate or dexamethasone with to sevoflurane anesthesia during primary cleft palate repair provides more vital hemodynamic state and decrease in postoperative vomiting and delirium when compared with control group.

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“…Replacement of ketamine with agents that have less prolonged depressant effects, or are reversible with specific antagonists could therefore be advantageous. In human medicine, the combination of fentanyl and midazolam has been widely used for conscious sedation for minor procedures, and at higher dose rates for surgery [ 12 – 15 ]. Combinations of opioids and benzodiazepines seem to be less effective in Rhesus macaques [ 16 ], however in other species, addition of medetomidine to these combinations produces fully reversible anaesthesia [ 17 – 19 ] and an initial report suggests this combination can be used successfully in non-human primates [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the effects of ketamine and fentanyl-midazolam-medetomidine for sedation of rhesus macaques (Macaca mulatta)

et al. 2016

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BackgroundThis study assessed the effects of sedation using a combination of fentanyl, midazolam and medetomidine in comparison to ketamine. Rhesus Macaques (Macaca mulatta), (n = 16, 5 males and 3 females randomly allocated to each treatment group) received either ketamine (KET) (10 mg.kg−1) or fentanyl-midazolam-medetomidine (FMM) (10 μg/kg−1; 0.5 mg.kg−1; 20 μg.kg−1) both IM. Oxygen (100 %) was provided by mask and heart rate, blood pressure, respiratory rate, EtCO2 and depth of sedation were assessed every 5 min for 20 min. After the last time point, FMM monkeys were reversed with atipamezole-naloxone (0.2 mg.kg−1; 10 μg.kg−1). Recovery was scored using clinical scoring scheme. Differences in physiological parameters and quality of sedation were compared using Area Under the Curve (AUC) method and either Mann-Witney or t-student tests.ResultsHeart rate (beats/min) (Ket = 119 ± 18; FMM = 89 ± 17; p = 0.0066), systolic blood pressure (mmHg) (Ket = 109 ± 10; FMM = 97 ± 10; p = 0.0313), and respiratory rate (breaths/min) (Ket = 39 ± 9; FMM = 29 ± 10; p = 0.0416) were significantly lower in the FMM group. End-tidal CO2 (mmHg) did not differ between the groups (KET = 33 ± 8; FMM = 42 ± 11; p = 0.0462). Although some depression of physiological parameters was seen with FMM, the variables all remained within the normal ranges in both groups. Onset of a sufficient degree of sedation for safe handling was more rapid with ketamine (KET = 2.9 ± 1.4 min; FMM = 7.9 ± 1.2 min; p = 0.0009), but FMM recovery was faster (KET = 21.4 ± 13.4 min; FMM = 9.1 ± 3.6 min; p = 0.0379) and of better quality (KET = 1.3 ± 0.9; FMM = 7.4 ± 1.9; p = 0.0009) most probably because of the effectiveness of the reversal agents used.ConclusionFMM provides an easily reversible immobilization with a rapid and good recovery quality and may prove a useful alternative to ketamine.

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Complications of sevoflurane–fentanyl versus midazolam–fentanyl anesthesia in pediatric cleft lip and palate surgery: a randomized comparison study

Cited by 17 publications

References 20 publications

Analysis of Complications in Primary Cleft Lips and Palates Surgery

Analysis of Complications in Primary Cleft Lips and Palates Surgery

Effect of intravenous magnesium sulphate or dexamethasone as adjuvants to sevoflurane anesthesia to prevent delirium during primary cleft palate repair, controlled randomized blind study

Comparison of the effects of ketamine and fentanyl-midazolam-medetomidine for sedation of rhesus macaques (Macaca mulatta)

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