RESUMEN
BACKGROUND: Both ketorolac and propacetamol are used postoperatively to control mild to moderate pain. This study compared the analgesic efficacy of ketorolac and propacetamol delivered either preoperatively or postoperatively, and assessed the preemptive analgesic effect of ketorolac and propacetamol for adenotonsillectomy. METHODS: One hundred and two pediatric patients were divided randomly into four groups. The K1 and P1 groups received ketorolac 1 mg/kg or propacetamol 30 mg/kg after induction, respectively, whereas the K2 and P2 groups received each drug at the end of the operation, respectively. After adenotonsillectomy, we measured the NRS (Numerical Rating Scale), FPS (Faces Pain Scale) and OPS (Objective Pain scale) at 15, 30 and 60 min after arriving at the postanesthesia care unit. RESULTS: There were no significant differences in the NRS, FPS and OPS between K1 and K2 and between P1 and P2 for 60 min after operation at the postanesthesia care unit. CONCLUSIONS: These results suggest that both ketorolac (1 mg/kg) and propacetamol (30 mg/kg) have no preemptive analgesic effects during 1 hour after adenotonsillectomy.
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Niño , Humanos , Acetaminofén , KetorolacoRESUMEN
BACKGROUND: Both ketorolac and propacetamol have been used to control mild to moderate pain after operation. Ketorolac is a non-steroid anti-inflammatory drug (NSAID) with strong analgesic activity, but should be avoided in patients with renal dysfunction or bleeding complications. Propacetamol is a prodrug of paracetamol and can be delivered intravenously. Importantly, it has fewer side effects and therefore generally considered safe. The purpose of this study is to compare the analgesic efficacy of ketorolac and propacetamol for pain control after tonsillectomy in pediatric patients. METHODS: The pediatric patients were randomly divided into three groups. All patients were given propofol and fentanyl for induction. During induction, one group received ketorolac 1 mg/kg (group K), another group received propacetamol 30 mg/kg (group P), and the other group received saline (group C). Postoperative pain was assessed by Visual Analogue Scale (VAS) and Faces Pain Scale (FPS) at 15, 30 and 60 min after arrival at the recovery room. RESULTS: VAS and FPS at 30 and 60 min after arrival were significantly lower in group K and P than in group C (P < 0.05). No adverse side effect was observed in all groups after tonsillectomy. CONCLUSIONS: Propacetamol can be used as a safe alternative to ketorolac for pain control after tonsillectomy in pediatric patients.
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Niño , Humanos , Acetaminofén , Analgesia , Fentanilo , Hemorragia , Ketorolaco , Dolor Postoperatorio , Propofol , TonsilectomíaRESUMEN
BACKGROUND: This study was designed to compare the maternal and neonatal effects of two volatile anesthetic agents, sevoflurane and desflurane during general anesthesia for cesarean section. METHODS: Sixty patients undergoing cesarean section were randomly selected and divided into two groups. After induction, sevoflurane (Group S, n = 30) and desflurane (Group D, n = 30) were administered to achieve steady-state end-tidal concentration of 1 vol% and 3 vol%, respectively. The maternal outcomes were evaluated at various time points in terms of hemodynamic changes and bispectral index (BIS). The neonatal characteristics were descripted with Apgar score and umbilical blood gas analysis. RESULTS: The BIS was lower in Group D than in Group S at 5 and 7 minutes after intubation and at delivery (P < 0.05). The value of BIS is between 40 to 60 in Group D appropriated with anesthetic depth during surgery. Other parameters as well as neonatal outcomes were not different between two groups. Intraoperative awareness of patients were not present at all. CONCLUSIONS: Maternal and neonatal effects were not significantly different between two groups and no adverse effects were seen. Despite of BIS over 60 at some period, maternal recall during surgery were absent postoperatively. Therefore, not only sevoflurane but also desflurane can be used for safe and effective anesthesia in cesarean section.