Ketamine and Dexmedetomidine for Day Care Anaesthesia in Paediatric Surgery

Yerramilli, Ravi Nagaprasad; Muralidhar, Aavula

doi:10.14260/jemds/2016/1191

Cited by 2 publications

(1 citation statement)

References 10 publications

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“…27 Yerramilli et al reported that dexmedetomidine ketamine combination provided smooth recovery with one improving the adverse effects of the other, in day case surgeries in pediatrics. 28…”

Section: Discussionmentioning

confidence: 99%

Ketodex versus opioid based anesthesia in cleft palate

Mohamed,

Abdelraof,

Noser

2024

Anaesth. pain intensive care

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Background & objective: Cleft palate is a congenital anomaly of the palate of the infants, and it may or may not be associated with cleft lip. The only remedy is surgical repair under general anesthesia. Postoperative pain relief in cleft palate repair surgery is very important to keep the infant or child calm and pain-free. It can only be achieved by use of analgesic drugs. We compared ketodex - a combination of ketamine and dexmedetomidine, versus opioid based anesthesia in cleft palate surgery as regards postoperative respiratory depression, need for oxygenation, and the emergence agitation. Methodology: Fifty children, aged 6 months to 5 y, undergoing cleft palate surgery under general anesthesia, were randomly assigned to either ketodex group (Group KD) or opioids group (Group OP). Group KD received ketamine 1mg/kg loading dose followed by infusion @ 0.1 mg/kg/h, and dexmedetomidine loading dose 1 µg/kg followed by infusion @ 0.2 µg/kg/h], isoflurane anesthesia. Group OP received fentanyl in a loading dose of 2 µg/kg followed by infusion @ 0.5 µg/kg/h, followed by isoflurane anesthesia. Heart rate, mean blood pressure, emergence agitation, extubation time, FLACC score for pain, surgeons’ satisfaction, and the adverse effects were noted. Results: Emergence agitation score was significantly lower in Group KD compared to Group OP. FLACC score showed insignificant difference between the two groups. There was no need for opioid administration in the PACU. Three patients in Group OP desaturated and needed oxygen supply. Incidence of vomiting was significantly higher in Group OP compared to Group KD (P = 0.022). Conclusion: Ketodex used in opioid free anesthesia for cleft palate repair surgery in children provides adequate pain relief without respiratory depression, and is a good alternative of routine opioid based general anesthesia. Key words: Ketamine; Dexmedetomidine; Opioids; Anesthesia; Recovery; Cleft Palate Surgery; Pediatrics Citation: Mohamed MM, Abdelraof AF, Noser MA. Ketodex versus opioid based anesthesia in cleft palate. Anaesth. pain intensive care 2024;28(1):74-80; DOI: 10.35975/apic.v28i1.2239 Received: May 31, 2023; Reviewed: June 06, 2023; Accepted: January 02, 2024

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Section: Discussionmentioning

confidence: 99%

Ketodex versus opioid based anesthesia in cleft palate

Mohamed,

Abdelraof,

Noser

2024

Anaesth. pain intensive care

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Effects of adding ketamine to dexmedetomidine on smooth recovery from isoflurane anesthesia in adults undergoing endoscopic sinus surgery

Amin

Kamel

2020

Egyptian Journal of Anaesthesia

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Background: Recovery from general anesthesia after endoscopic sinus surgery can abruptly become dangerous and having serious complications leading to lost intravenous cannulas, disconnected cables, self extubation, physical injury, increased pain and hemorrhage. This study aimed to evaluate the effects of adding ketamine to dexmedetomidine on smooth recovery from isoflurane anesthesia in adults undergoing endoscopic sinus surgery. Methods: A prospective double-blind randomized controlled study. Ten minutes before ending of surgery, 94 patients were randomly divided into two equal groups: Group (KD) (n = 47): received ketamine 0.5 mg/kg and dexmedetomidine 0.5ug/kg completed to 10 ml 0.9% normal saline and Group (C) (n = 47): received 10 ml 0.9% normal saline. Result: The extubation, recovery and discharge times were statistically significant prolonged in KD group (6.82 ± 0.76, 8.68 ± 0.81 and17.63 ± 4.8) min compared to C group (4.34 ± 0.61, 6.3 ± 0.72 and14.8 ± 2.7) min respectively. The median Ricker Sedation-Agitation scale (RSAS) score at the recovery time, at admission to PACU, at PACU and at discharge from PACU was statistically significant lower in KD group compared to C group (p < 0.0001). The mean Visual Analogue Scale (VAS) score on arrival to PACU, discharge from PACU, one hour, 2hs, 4hs, 8hs, 12hs and 24hs postoperative and pethidine requirements were statistically significant lower in KD group compared to C group (p < 0.0001). No statistically significant difference in side-effects between groups. Conclusion: Adding 0.5 mg ketamine to 0.5ug dexmedetomidine provides smooth recovery from isoflurane anesthesia in adults undergoing endoscopic sinus surgery.

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Ketamine and Dexmedetomidine for Day Care Anaesthesia in Paediatric Surgery

Cited by 2 publications

References 10 publications

Ketodex versus opioid based anesthesia in cleft palate

Ketodex versus opioid based anesthesia in cleft palate

Effects of adding ketamine to dexmedetomidine on smooth recovery from isoflurane anesthesia in adults undergoing endoscopic sinus surgery

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