Low-Dose Dexmedetomidine Reduces Emergence Agitation after Desflurane Anaesthesia in Children Undergoing Strabismus Surgery

Kim, Jeongmin; Kim, So Yeon; Lee, Jae H.; Kang, Young Ran; Koo, Bon‐Nyeo

doi:10.3349/ymj.2014.55.2.508

Cited by 52 publications

(59 citation statements)

References 45 publications

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“….h À1 has been reported to reduce the incidence of emergence delirium [35][36][37][38], as has a single bolus dose of 0.3 lg.kg À1 dexmedetomidine [39]. Although most studies have been performed in children undergoing adenotonsillectomy or squint surgery, studies in children having MRI scans are particularly useful because they eliminate pain as a confounding factor.…”

mentioning

confidence: 99%

Emergence delirium in children

Wong

Bailey

2015

Anaesthesia

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mentioning

confidence: 99%

Emergence delirium in children

Wong

Bailey

2015

Anaesthesia

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“…Ketamine works on the NMDA receptors and helps in establishing local anesthesia hence lowering the pain felt. 19,20 Pre-injection with Ketamine reduces pain from 84% to 26% and also reduced the blood pressure reducing effects as caused by the administration of propofol. 21 The pain felt by the patient after injection of propofol can be immediate or delayed by 10 to 20 seconds.…”

Section: Discussionmentioning

confidence: 99%

Pain during intravenous Propofol injection and its prevention in the pediatric population. A randomized controlled trial.

Raza¹,

Siddiqui²,

Soomro³

et al. 2020

TPMJ

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Objectives: The aim of our study is to observe the pain difference as experienced by the pediatric patient when administered different preparations of propofol utilizing the verbal rating scale. Study Design: Prospective double-blind randomized control trial. Setting: A large tertiary care hospital in Karachi, Pakistan. Period: 6 months from June 2016 to November 2016. Material & Methods: The final patient population included in the study was n= 180 and were divided into six groups. These patients received general anesthesia and underwent surgery. Patients in Group A received 2ml of normal saline and a mixture of propofol and normal saline after waiting for half a minute. Group B patients received 0.5mg/kg Lidocaine followed by normal saline after waiting for half a minute. Group C received 2ml of normal saline followed by a mixture of propofol and Lidocaine after half a minute. Group D received 0.2mg/kg of Ketamine followed by a mixture of normal saline and propofol. Group E patients received 2ml of normal saline followed by a mixture of propofol and Ketamine half a minute later. And finally, patients belonging to group F received 2ml of normal saline followed by a mixture of propofol M/LCT and normal saline half a minute later respectively. Results: The gender, age, body weight and ASA grade of all the pediatric patients were similar having a P value of >0.05. The incidence rate of propofol injection pain in the groups were found to be Group A= 76.66%, Group B= 66.66%, Group C= 50%, Group D= 60%, Group E= 63.33%, Group F= 60% respectively. The incidence rate for adverse events was significantly lower in all the groups as compared to Group A that is the normal saline and propofol group having a p-value of less than 0.01. And the incidence rate of adverse events was lower in Groups C, D, E, and F were significantly lower than Group B having a p-value of less than 0.05. All the experimental groups had significantly lower scores of the VRS scale as compared to the control group (Group A) and the intergroup differences were found to be statistically significant having a p-value of less than 0.01. Conclusion: In our study, we found that the injection pain of propofol administration in the pediatric population was significantly reduced when using M/LCT pre-injection, 0.5mg/kg lidocaine or 0.2mg/kg of Ketamine. Another good combination is mixing 180mg propofol with 40mg of lidocaine or mixing propofol with 16mg of Ketamine.

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“…As the receptor antagonist for N-methyl-D-aspartate, ketamine allows local anesthesia19 and exerts an analgesic effect at low dose 20. Pre-injection of 10 mg ketamine can reduce the incidence rate of injection pain from 84% to 26% and also partially counteract the blood pressure-reducing effect of propofol 21…”

Section: Discussionmentioning

confidence: 99%

A randomized double-blinded prospective study on the role of propofol in pediatric anesthesia

2017

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Objective:Propofol is a new anesthetic agent in clinical practice, but randomized double-blinded prospective studies on its role in pediatric anesthesia remain limited. We aimed to compare the preventive effects of pre-injected lidocaine or ketamine and its pre-mixture on the anesthesia-induced injection pain of propofol using a randomized double-blinded prospective method, and to compare the outcomes with those of medium-/long-chain propofol (M/LCT).Methods:A total of 360 pediatric patients (aged 5-12 years old) who received elective surgery were randomly divided into six groups (n= 60) as follows. S group: control group; L group: lidocaine group; L + P group: lidocaine + propofol group; K group: ketamine group; K + P group: ketamine + propofol group; M group: M/LCT group. After the drug fluid completely entered the cubital vein, the venous access was closed. During propofol injection, the injection pain was scored using the VRS 4-point scale. Meanwhile, the heart rates before and during injection were recorded, the adverse reactions during and after injection were observed, and the incidence rate and degree of pain were evaluated.Results:The VRS 4-point scale showed that the incidence rates of injection pain of S group, L group, L + P group, K group, K + P group and M group were 78.3%, 66.67%, 51.66%, 43.33%, 48.33% and 45% respectively. The incidence rates of injection pain of all experimental groups were significantly lower than that of S group (P<0.01). The incidence rates of injection pain of L + P group, K group, K + P group and M group were significantly lower than that of L group (P<0.05). The differences among the other groups were not statistically significant.Conclusions:Intravenous pre-injection of lidocaine, ketamine or those mixed with propofol can all significantly reduce the incidence rate of injection pain of propofol.

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Low-Dose Dexmedetomidine Reduces Emergence Agitation after Desflurane Anaesthesia in Children Undergoing Strabismus Surgery

Cited by 52 publications

References 45 publications

Emergence delirium in children

Emergence delirium in children

Pain during intravenous Propofol injection and its prevention in the pediatric population. A randomized controlled trial.

A randomized double-blinded prospective study on the role of propofol in pediatric anesthesia

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