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IMPACT OF INTRAOPERATIVE INTRAVENOUS ADMINISTRATION OF KETAMINE, FENTANYL OR PROPOFOL IN DECREASING PEDIATRIC POST-TONSILLECTOMY EMERGENCE AGITATION
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Zahi Almajali *   , Emil Batarseh , Ahmad Masadeh , Pharm Mustafa rafeeq khalil , RN Hazem Alkhaldi |
| MD, JBA |
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Abstract: (9777 Views) |
| To evaluate the frequency of emergence agitation after tonsillectomy in children administered ketamine, fentanyl or propofol during surgery.
Our prospective and double-blind investigation included 273 children patients, of both sexes, aged 3-11 years, classed I by the American society of anesthesiologists and scheduled for tonsillectomy under general endotracheal anesthesia at Queen Rania hospital for children, KHMC, Amman, Jordan during the period April 2012-April 2013.
Children patients received intravenous induction of anesthesia using fentanyl 2 mcg/kg,propofol 2 mg/kg and tracurium 0.5mg/kg ,after which a proper endotracheal tube size was secured through which a mixture of nitrous oxide/oxygen with 1 MAC of isoflurane was delivered.At the end of surgical procedure, patients received in a random fashion an intravenous dose of either ketamine 1mg/kg(GI,n=93), fentanyl 1 mcg/kg(GII,n=89) or propofol 1mg/kg(GIII,n=91).Incidence and intensity of postoperative emergence agitation was assessed using the five-step emergence agitation scale where 1 meant obtunded with no response to stimulation, 2 meant asleep but responsive to movement or stimulation, 3 meant awake and responsive, 4 meant crying and 5 meant thrashing behavior that requires restraint. The patient scale of more or equal to 4 was considered as having emergence agitation. The frequency of emergence agitation was analyzed statistically using Chi-square test .Significant P –value was considered significant if it was <0.05.
Postoperative emergence agitation was 4.4% in propofol group,5.6% in fentanyl group(P>0.05) and 13.97% in ketamine group (P<0.05).
The incidence of postoperative emergence agitation was significantly less in groups using intraoperative fentanyl or propofol compared to group using ketamine . Int j med invest.2(3):151-158 October 2013
152 International journal of medical investigation www.intjmi.com |
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| Keywords: Intra:operative, venous:fentanyl, ketamine, propofol, isoflurane, paediatric, post-tonsillectomy:emergence agitation |
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Type of Study: Research |
Subject:
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