Effect of ketamine on emergence agitation following septoplasty: a randomized clinical trial.

BACKGROUND AND OBJECTIVES: The risk of emergence agitation (EA) is high in patients undergoing nasal surgery. The aim of the present study was to investigate the incidence of EA in adults undergoing septoplasty and the effect of ketamine on EA. METHODS: In this randomized study, a total of 102 ASA I-II patients who underwent septoplasty between July 2018 and April 2019 were divided into two groups: ketamine (Group-K, n=52) and saline (Group-S, n=50). After anesthesia induction, Group-K was intravenously administered 20mL of saline containing 1mgkg-1 ketamine, whereas Group-S was administered 20mL of saline. Sedation and agitation scores at emergence from anesthesia, incidence of cough, emergence time, and response to verbal stimuli time were recorded. The sedation/agitation and pain levels were recorded for 30minutes in the recovery unit. RESULTS: There was no significant difference between the groups in terms of the incidence of EA (Group-K: 15.4%, Group-S: 24%). The incidence of cough during emergence was higher in Group-S than in Group-K, but the response time to verbal stimuli and emergence time were shorter in Group-S. The sedation and agitation scores were similar after surgery. Pain scores were higher in Group-S at the time of admission to the recovery unit and were similar between groups in the other time points. CONCLUSION: Administration of 1mgkg-1 ketamine after anesthesia induction does not affect the incidence of EA in patients undergoing septoplasty, but it prolongs the emergence and response time to verbal stimuli and reduces the incidence of cough.

Integrated Pulmonary Index (IPI) monitorization under sedation in cataract surgery with phacoemulsification technique.

PURPOSE: We aimed to investigate that change of IPI values after sedation of patients undergoing cataract surgery under sedation. METHODS: We included 50 patients (ASA I-III) undergoing cataract surgery under sedation by phacoemulsification method in this prospective observational study. IPI, SpO2, ETCO2, respiratory rate (RR), peripheral pulse rate (PR), hemodynamic data and BIS values and perioperative complications were recorded. RESULTS: Compared to baseline values, RR value at 5th min, RR, PR, IPI values at 10th min and RR, PR values at 15th min were significantly low and heart rate value at 15th min and arterial pressure, bispectral index (BIS) values at 5th min, 10th min, 15th min, 20th min, 25th min and 30th min were lower than baseline values. CONCLUSIONS: IPI monitoring will provide guidance during sedation of patients with comorbid diseases undergoing cataract surgery by phacoemulsification method.

Comparison of I-gel with Classic Laryngeal Mask Airway Regarding the Ease of Use and Clinical Performance.

OBJECTIVE: I-gel is a new supraglottic airway device without an inflatable cuff. We aimed to compare I-gel and the classic laryngeal mask airway (LMA) regarding the ease of use and clinical performance in Turkish population. METHODS: Fifty American Society of Anesthesiologists (ASA) I-II patients were randomly allocated into two groups: Group I-gel and Group LMA. Insertion time and success in first attempt were recorded. Peak, plato and mean airway pressures, EtCO2, airway compliance and leak volume were periodically recorded during the operation. The presence of blood on device removal and postoperative sore throat were also assessed. RESULTS: The device insertion time in Group I-gel was shorter than that in Group LMA (21.00±4.15 vs. 30.40±12.17 s, p=0.001). The success rate in first attempt, peak, plato and mean airway pressures, EtCO2 and airway compliance did not differ between the groups. The leak volume was lower in Group I-gel 5 and 45 min after insertion (p=0.041 and p=0.027). The presence of blood on device removal and postoperative sore throat were similar in both groups. CONCLUSION: I-gel may be a more advantageous supraglottic airway device compared with LMA.