Effect of ketamine versus thiopental sodium anesthetic induction and a small dose of fentanyl on emergence agitation after sevoflurane anesthesia in children undergoing brief ophthalmic surgery / 대한마취과학회지

BACKGROUND: Emergence agitation (EA) in children after sevoflurane anesthesia is common. The purpose of this study was to compare the incidences of EA between ketamine and thiopental sodium induction in children underwent sevoflurane anesthesia. We also evaluated if a small dose of fentanyl could reduce the incidence of EA. METHODS: The patients who were scheduled for strabismus or entropion surgery were divided into 4 groups. The patients in Groups 1 and 2 were induced anesthesia with ketamine 1.5 mg/kg; those in Groups 3 and 4 were induced with thiopental sodium 5 mg/kg. The patients in Groups 1 and 3 received an injection of fentanyl 1.5 microgram/kg, whereas the patients in Groups 2 and 4 received IV saline of the same volume. Anesthesia was maintained with sevoflurane. The recovery characteristics and EA in recovery room were assessed. RESULTS: The incidence of EA was significantly higher in Groups 2 and 4 and there was no difference between Groups 2 and 4. Group 2 had almost an eleven-fold higher risk of developing EA than did Group 1, and the incidence of EA in Group 4 was sixty-nine-fold higher than that of Group 1. The risk factor for EA was only the kind of medication. Preoperative anxiety had no significant correlation with EA. CONCLUSIONS: The incidence of EA after sevoflurane anesthesia is similar between ketamine and thiopental sodium anesthetic induction in children undergoing pediatric ophthalmic surgery. Also, the addition of a small dose of fentanyl after anesthetic induction decreases the incidence of EA.

Effect of ketamine versus thiopental sodium anesthetic induction and a small dose of fentanyl on emergence agitation after sevoflurane anesthesia in children undergoing brief ophthalmic surgery / 대한마취과학회지

BACKGROUND: Emergence agitation (EA) in children after sevoflurane anesthesia is common. The purpose of this study was to compare the incidences of EA between ketamine and thiopental sodium induction in children underwent sevoflurane anesthesia. We also evaluated if a small dose of fentanyl could reduce the incidence of EA. METHODS: The patients who were scheduled for strabismus or entropion surgery were divided into 4 groups. The patients in Groups 1 and 2 were induced anesthesia with ketamine 1.5 mg/kg; those in Groups 3 and 4 were induced with thiopental sodium 5 mg/kg. The patients in Groups 1 and 3 received an injection of fentanyl 1.5 microgram/kg, whereas the patients in Groups 2 and 4 received IV saline of the same volume. Anesthesia was maintained with sevoflurane. The recovery characteristics and EA in recovery room were assessed. RESULTS: The incidence of EA was significantly higher in Groups 2 and 4 and there was no difference between Groups 2 and 4. Group 2 had almost an eleven-fold higher risk of developing EA than did Group 1, and the incidence of EA in Group 4 was sixty-nine-fold higher than that of Group 1. The risk factor for EA was only the kind of medication. Preoperative anxiety had no significant correlation with EA. CONCLUSIONS: The incidence of EA after sevoflurane anesthesia is similar between ketamine and thiopental sodium anesthetic induction in children undergoing pediatric ophthalmic surgery. Also, the addition of a small dose of fentanyl after anesthetic induction decreases the incidence of EA.

The impact of nasogastric tube placement on the postoperative nausea and vomiting of patients who are undergoing cardiac surgery

BACKGROUND: The incidence of postoperative nausea and vomiting after cardiac surgery is 30-40%.The role of a nasogastric tube for reducing the PONV is still controversial. METHODS: 92 patients who were undergoing cardiac surgery with cardiopulmonary bypass were randomized to a receive nasogastric tube after induction of anesthesia (Group 2) or they were placed in the control group (no nasogastric tube) (Group 1).The patients with a history of gastric/esophageal surgery, esophageal varix, esophageal stricture and/or a history of antiemetic treatment were excluded.Routine fast-track cardiac anesthesia and postoperative care were employed for all the patients.The incidence of PONV was recorded hourly for the first four hours after extubation and then every 4 h afterwards for 24 h.The usage of antiemetics and pain medication was also recorded.The data was analyzed with t-tests and chi-square tests for the continuous variables and the categorical data, respectively.P values < 0.05 were considered statistically significant. RESULTS: The groups were similar with respect to the demographic data, the surgical characteristics and the opioid usage.There was no significant difference in the incidence of PONV and the antiemetic usage between the two groups. CONCLUSIONS: This study showed that placement of a nasogastric tube did not have an impact on the incidence of PONV or the requirements for antiemetics after cardiac surgery.The results of this study do not support the use of a nasogastric tube to reduce PONV after cardiac surgery.