[Preemptive nebulized ketamine for pain control after tonsillectomy in children: randomized controlled trial].
| Autor: | Abdel-Ghaffar HS; Assiut University, Faculty of Medicine, Department of Anesthesia and Intensive Care, Assiut, Egito., Abdel-Wahab AH; Assiut University, Faculty of Medicine, Department of Anesthesia and Intensive Care, Assiut, Egito. Electronic address: amanihassan1976@yahoo.com., Roushdy MM; Assiut University, Faculty of Medicine, Department of Ear, Nose and Throat, Assiut, Egito., Osman AMM; Assiut University, South Egypt Cancer Institute, Department of Pediatric Oncology, Assiut, Egito. |
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| Jazyk: | portugalština |
| Zdroj: | Brazilian journal of anesthesiology (Elsevier) [Braz J Anesthesiol] 2019 Jul - Aug; Vol. 69 (4), pp. 350-357. Date of Electronic Publication: 2019 Jul 28. |
| DOI: | 10.1016/j.bjan.2019.03.007 |
| Abstrakt: | Objectives: The administration of ketamine as nebulized inhalation is relatively new and studies on nebulized ketamine are scarce. We aimed to investigate the analgesic efficacy of nebulized ketamine (1 and 2mg.kg -1 ) administered 30min before general anesthesia in children undergoing elective tonsillectomy in comparison with intravenous ketamine (0.5mg.kg -1 ) and saline placebo. Methods: One hundred children aged (7-12) years were randomly allocated in four groups (n=25) receive; Saline Placebo (Group C), Intravenous Ketamine 0.5mg.kg -1 (Group K-IV), Nebulized Ketamine 1mg.kg -1 (Group K-N1) or 2mg.kg -1 (Group K-N2). The primary endpoint was the total consumption of rescue analgesics in the first 24h postoperative. Results: The mean time to first request for rescue analgesics was prolonged in K-N1 (400.9±60.5min, 95% CI 375.9-425.87) and K-N2 (455.5±44.6min, 95% CI 437.1-473.9) groups compared with Group K-IV (318.5±86.1min, 95% CI 282.9-354.1) and Group C (68.3±21.9min, 95% CI 59.5-77.1; p<0.001), with a significant difference between K-N1 and K-N2 Groups (p<0.001). The total consumption of IV paracetamol in the first 24h postoperative was reduced in Group K-IV (672.6±272.8mg, 95% CI 559.9-785.2), Group K-N1 (715.6±103.2mg, 95% CI 590.4-840.8) and Group K-N2 (696.6±133.3mg, 95% CI 558.8-834.4) compared with Control Group (1153.8±312.4mg, 95% CI 1024.8-1282.8; p<0.001). With no difference between intravenous and Nebulized Ketamine Groups (p=0.312). Patients in intravenous and Nebulized Ketamine Groups showed lower postoperative VRS scores compared with Group C (p<0.001), no differences between K-IV, K-N1 or K-N2 group and without significant adverse effects. Conclusion: Preemptive nebulized ketamine was effective for post-tonsillectomy pain relief. It can be considered as an effective alternative route to IV ketamine. (Copyright © 2019. Publicado por Elsevier Editora Ltda.) |
| Databáze: | MEDLINE |
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