Factors associated with children's perception of pain following dental treatment.

PURPOSE: To assess children's perception of pain during routine dental procedures and associated factors. METHODS: A cross-sectional study was performed including 192 children aged 6-13 years, who visited a university paediatric dental clinic. Mothers were interviewed to obtain information about demographic and socioeconomic data, and psychosocial characteristics. During dental treatment, children's behaviour was assessed using Frankl's Behaviour Scale. Dental procedures were recorded according to complexity of treatment from dental records. Immediately after the dental procedure, perception of pain was assessed using the Faces Pain Scale-Revised. Poisson regression analysis was used to assess the association between potential predictor variables and perception of pain (P < 0.05 was considered significant). RESULTS: Overall, the mean pain score was 1.5 (SD 2.4). Higher levels of pain were reported by children who demonstrated non-cooperative behaviour during the treatment (RR = 2.39, 95% CI = 1.23-4.64), who were administered local analgesia (RR = 2.36, 95% CI = 1.31-4.27), and who reported dental pain during the previous 4 weeks (RR = 1.60, 95% CI = 1.04-2.47). CONCLUSION: Perception of pain may be influenced by pre-operative pain and use of local analgesia, and is associated with non-cooperative behaviour during treatment.

Comparison of the effects of maropitant, lidocaine, and dextroketamine administered by the intratesticular route in dogs undergoing elective orchiectomy

Background: Balanced anesthesia achieved with combinations of inhaled and injectable drugs administered systemicallyor in loco-regional anesthetic blocks, is widely used in veterinary medicine. The use of anesthesia and/or local analgesiahas already demonstrated benefits in the performance of elective orchiectomy in different species, there is no literature thatevaluates the use of the maropitant intratesticular route. The present study evaluated the cardiorespiratory variables andanalgesia produced by intratesticular blockade with maropitant, lidocaine, or dextroketamine during the trans-operativeperiod along with the discharge and anesthetic recovery of dogs that underwent elective orchiectomy.Materials, Methods & Results: Used twenty-four dogs from routine elective orchiectomy, considered healthy based onthe results of clinical and hematological tests. The animals were randomly divided into three groups and was applied intratesticularly 2% lidocaine at a dose of 1 mg/kg (GL), 5% dextrocetamina at a dose of 2.5 mg/kg (GC), or 1% maropitantat a dose of 1 mg/kg (GM). Anesthesia induction was performed with propofol (to effect), and stabilization of inhalationalanesthesia was achieved with 1.7 V% of sevoflurane diluted in 100% oxygen administered through a calibrated vaporizerand appropriate anesthetic system based on the animals weight, being kept under spontaneous ventilation, After induction, we waited 10 min for stabilization of exhaled anesthetic concentration and then administered one of the treatmentsintratesticularly. After five min from the local block the surgical procedure was started during up to 15 min. Heart rate(HR), respiratory rate (RR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure(MAP), oxygen saturation of hemoglobin (SatO2), end-tidal carbon dioxide partial pressure (EtCO2), end-tidal sevofluraneconcentration...(AU)

Comparison of the effects of maropitant, lidocaine, and dextroketamine administered by the intratesticular route in dogs undergoing elective orchiectomy

Background: Balanced anesthesia achieved with combinations of inhaled and injectable drugs administered systemicallyor in loco-regional anesthetic blocks, is widely used in veterinary medicine. The use of anesthesia and/or local analgesiahas already demonstrated benefits in the performance of elective orchiectomy in different species, there is no literature thatevaluates the use of the maropitant intratesticular route. The present study evaluated the cardiorespiratory variables andanalgesia produced by intratesticular blockade with maropitant, lidocaine, or dextroketamine during the trans-operativeperiod along with the discharge and anesthetic recovery of dogs that underwent elective orchiectomy.Materials, Methods & Results: Used twenty-four dogs from routine elective orchiectomy, considered healthy based onthe results of clinical and hematological tests. The animals were randomly divided into three groups and was applied intratesticularly 2% lidocaine at a dose of 1 mg/kg (GL), 5% dextrocetamina at a dose of 2.5 mg/kg (GC), or 1% maropitantat a dose of 1 mg/kg (GM). Anesthesia induction was performed with propofol (to effect), and stabilization of inhalationalanesthesia was achieved with 1.7 V% of sevoflurane diluted in 100% oxygen administered through a calibrated vaporizerand appropriate anesthetic system based on the animal’s weight, being kept under spontaneous ventilation, After induction, we waited 10 min for stabilization of exhaled anesthetic concentration and then administered one of the treatmentsintratesticularly. After five min from the local block the surgical procedure was started during up to 15 min. Heart rate(HR), respiratory rate (RR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure(MAP), oxygen saturation of hemoglobin (SatO2), end-tidal carbon dioxide partial pressure (EtCO2), end-tidal sevofluraneconcentration...

Ketamine as an adjunct to bupivacaine in infra-orbital nerve block analgesia after cleft lip repair / Cetamina como adjuvante de bupivacaína em bloqueio do nervo infraorbitário para analgesia após correção de lábio leporino

Abstract Objectives: We conducted this study to investigate the safety and analgesic efficacy of the addition of Ketamine to Bupivacaine in bilateral extra-oral infra-orbital nerve block in children undergoing cleft lip surgeries. Methods: Sixty patients were randomly allocated into two groups (n = 30), Group B received infra-orbital nerve block with 2 mL of 0.25% Bupivacaine and Group BK received 0.5 mg.kg-1 Ketamine for each side added to 1 mL of 0.5% Bupivacaine solution diluted up to 2 mL solution to 0.25% Bupivacaine concentration. Assessment parameters included; hemodynamics, recovery time, time to first oral intake, postoperative Faces Legs Activity Cry Consolability (FLACC) scores, Four-point Agitation scores, analgesic consumption and adverse effects. Results: Patients in Group BK showed lower postoperative FLACC scores during all recorded time points (p < 0.0001). Two patients in Group BK versus 12 in Group B requested for postoperative rescue analgesia (p < 0.001). There were no differences between groups in time, minutes (min), to first request for rescue analgesia. Patients in Group BK reported lower analgesic consumption (366.67 ± 45.67 vs. 240.0 ± 0.0 mg, p < 0.04). The time to first oral intake was significantly reduced in Group BK (87.67 ± 15.41 vs. 27.33 ± 8.68 min, p < 0.001). Lower postoperative Agitation scores were recorded in Group BK patients that reached a statistical significance at 45 min (0.86 ± 0.11 vs. 0.46 ± 0.16, p < 0.04) and in the first hour (h) postoperatively (1.40 ± 0.17 vs. 0.67 ± 0.14, p < 0.003). Higher parent satisfaction scores were recorded in Group BK (p < 0.04) without significant adverse effects. Conclusions: The addition of Ketamine to Bupivacaine has accentuated the analgesic efficacy of infra-orbital nerve block in children undergoing cleft lip repair surgeries.

Resumo Objetivos: Realizamos este estudo para avaliar a segurança e eficácia da analgesia com a adição de cetamina à bupivacaína em bloqueio do nervo infraorbitário, bilateral e extraoral, em crianças submetidas à cirurgia de lábio leporino. Métodos: Foram randomicamente alocados 60 pacientes em dois grupos (n = 30): o Grupo B recebeu bloqueio do nervo infraorbitário com bupivacaína a 0,25% (2 mL) e o Grupo BC recebeu bloqueio com cetamina (0,5 mg.kg-1) em cada lado, mais a adição de 1 mL de solução de bupivacaína a 0,5% diluída até 2 mL da concentração a 0,25%. Os parâmetros de avaliação incluíram: hemodinâmica, tempo de recuperação, tempo até a primeira ingestão oral, escores da escala FLACC (que avalia a expressão facial [Face], os movimentos das pernas [Legs], a atividade [Activity], o choro [Cry] e a consolabilidade [Consolability]), escores de agitação em escala de quatro pontos, consumo de analgésicos e efeitos adversos no pós-operatório. Resultados: Os pacientes do Grupo BC apresentaram escores FLACC mais baixos em todos os momentos mensurados no pós-operatório (p < 0,0001). Dois pacientes do Grupo BC versus 12 do Grupo B solicitaram analgesia de resgate no pós-operatório (p < 0,001). Não houve diferenças entre os grupos em relação ao tempo até a primeira solicitação de analgesia de resgate. Os pacientes do Grupo BC relataram consumo menor de analgésicos (366,67 ± 45,67 vs. 240,0 ± 0,0 mg, p < 0,04). O tempo em minutos (min) até a primeira ingestão oral foi significativamente reduzido no Grupo BC (87,67 ± 15,41 vs. 27,33 ± 8,68 min, p < 0,001). Escores mais baixos de agitação no pós-operatório foram registrados para os pacientes do Grupo BC, com significância estatística no tempo de 45 min (0,86 ± 0,11 vs. 0,46 ± 0,16; p < 0,04) e na primeira hora de pós-operatório (1,40 ± 0,17 vs. 0,67 ± 0,14; p < 0,003). Índices mais altos de satisfação dos pais foram registrados no Grupo BC (p < 0,04), sem efeitos adversos significativos. Conclusões: A adição de cetamina à bupivacaína acentuou a eficácia analgésica do bloqueio do nervo infraorbitário em crianças submetidas à cirurgia de correção de lábio leporino.

[Ketamine as an adjunct to bupivacaine in infra-orbital nerve block analgesia after cleft lip repair]. / Cetamina como adjuvante de bupivacaína em bloqueio do nervo infraorbitário para analgesia após correção de lábio leporino.

OBJECTIVES: We conducted this study to investigate the safety and analgesic efficacy of the addition of Ketamine to Bupivacaine in bilateral extra-oral infra-orbital nerve block in children undergoing cleft lip surgeries. METHODS: Sixty patients were randomly allocated into two groups (n=30), Group B received infra-orbital nerve block with 2mL of 0.25% Bupivacaine and Group BK received 0.5mg.kg-1 Ketamine for each side added to 1mL of 0.5% Bupivacaine solution diluted up to 2mL solution to 0.25% Bupivacaine concentration. Assessment parameters included; hemodynamics, recovery time, time to first oral intake, postoperative Faces Legs Activity Cry Consolability (FLACC) scores, Four-point Agitation scores, analgesic consumption and adverse effects. RESULTS: Patients in Group BK showed lower postoperative FLACC scores during all recorded time points (p<0.0001). Two patients in Group BK versus 12 in Group B requested for postoperative rescue analgesia (p<0.001). There were no differences between groups in time, minutes (min), to first request for rescue analgesia. Patients in Group BK reported lower analgesic consumption (366.67±45.67 vs. 240.0±0.0mg, p<0.04). The time to first oral intake was significantly reduced in Group BK (87.67±15.41 vs. 27.33±8.68min, p<0.001). Lower postoperative Agitation scores were recorded in Group BK patients that reached a statistical significance at 45min (0.86±0.11 vs. 0.46±0.16, p<0.04) and in the first hour (h) postoperatively (1.40±0.17 vs. 0.67±0.14, p<0.003). Higher parent satisfaction scores were recorded in Group BK (p<0.04) without significant adverse effects. CONCLUSIONS: The addition of Ketamine to Bupivacaine has accentuated the analgesic efficacy of infra-orbital nerve block in children undergoing cleft lip repair surgeries.

Influência da lidocaína ou da dextrocetamina pela via intratesticular na anestesia com sevoflurano em cães submetidos à orquiectomia eletiva / Influence of intratesticular administration of lidocaine or dextroketamine in dogs undergoing elective orchiectomy anesthetized with sevoflurane

Background: Elective orchiectomy is one of the most performed surgeries in the veterinary practice and is considered a moderately painful procedure; thus, the use of balanced anesthesia is a good choice. Local anesthetics have shown to be effective for intratesticular and spermatic cord blocks in several species; however, there have been no reports of the use of dextroketamine with this purpose. The objective of this study was to evaluate cardiovascular and respiratory variables, and analgesia produced by intratesticular block using dextroketamine or lidocaine, as well as to assess post-anesthesia recovery and discharge in dogs subjected to elective orchiectomy under inhalation anesthesia with sevoflurane.Materials, Methods & Results: Sixteen dogs which underwent elective orchiectomy were included in this study. All animals were healthy based on clinical and hematological examinations. The animals were randomly distributed into two groups, in which 2% lidocaine at 1 mg/kg (LG) or 5% dextroketamine at 2.5 mg/kg (KG) were administered by the intratesticular route. In both groups, anesthesia was induced with propofol to effect, and maintained with 1.7 V% sevoflurane diluted in 100% oxygen, administered through a calibrated vaporizer and appropriate anesthetic system based on the animal’s weight, kept under spontaneous ventilation. After induction, 10 min were given for stabilization of exhaled anesthetic concentration before one of the treatments was administered intratesticularly. Five min after administration of the local block, the surgical procedure was performed, which lasted up to 15 min.[...]

Influência da lidocaína ou da dextrocetamina pela via intratesticular na anestesia com sevoflurano em cães submetidos à orquiectomia eletiva / Influence of intratesticular administration of lidocaine or dextroketamine in dogs undergoing elective orchiectomy anesthetized with sevoflurane

Background: Elective orchiectomy is one of the most performed surgeries in the veterinary practice and is considered a moderately painful procedure; thus, the use of balanced anesthesia is a good choice. Local anesthetics have shown to be effective for intratesticular and spermatic cord blocks in several species; however, there have been no reports of the use of dextroketamine with this purpose. The objective of this study was to evaluate cardiovascular and respiratory variables, and analgesia produced by intratesticular block using dextroketamine or lidocaine, as well as to assess post-anesthesia recovery and discharge in dogs subjected to elective orchiectomy under inhalation anesthesia with sevoflurane.Materials, Methods & Results: Sixteen dogs which underwent elective orchiectomy were included in this study. All animals were healthy based on clinical and hematological examinations. The animals were randomly distributed into two groups, in which 2% lidocaine at 1 mg/kg (LG) or 5% dextroketamine at 2.5 mg/kg (KG) were administered by the intratesticular route. In both groups, anesthesia was induced with propofol to effect, and maintained with 1.7 V% sevoflurane diluted in 100% oxygen, administered through a calibrated vaporizer and appropriate anesthetic system based on the animals weight, kept under spontaneous ventilation. After induction, 10 min were given for stabilization of exhaled anesthetic concentration before one of the treatments was administered intratesticularly. Five min after administration of the local block, the surgical procedure was performed, which lasted up to 15 min.[...](AU)