Ketamine or alfentanil administration prior to propofol anaesthesia: the effects on ProSeal laryngeal mask airway insertion conditions and haemodynamic changes in children.

This study was designed to compare the effects of ketamine and alfentanil administered prior to induction of anaesthesia with propofol, on the haemodynamic changes and ProSeal laryngeal mask airway (PLMA) insertion conditions in children. Eighty children, aged between 3-132 months, were randomly allocated to receive either alfentanil 20 microg.kg(-1) (alfentanil group) or ketamine 0.5 mg.kg(-1) (ketamine group) before induction of anaesthesia. Ninety seconds following the administration of propofol 4 mg.kg(-1), a PLMA was inserted. In the ketamine group, heart rate and mean arterial pressure were higher during the study period compared with the alfentanil group (p < 0.05). The time for the return of spontaneous ventilation was prolonged in the alfentanil group (p = 0.004). In conclusion, we found that the administration of ketamine 0.5 mg.kg(-1) with propofol 4 mg.kg(-1) preserved haemodynamic stability, and reduced the time to the return of spontaneous ventilation, compared with alfentanil 20 microg.kg(-1) during PLMA placement. In addition, the conditions for insertion of the PLMA with ketamine were similar to those found with alfentanil.

The post-operative analgesic effects of a combination of gabapentin and paracetamol in patients undergoing abdominal hysterectomy: a randomized clinical trial.

BACKGROUND: The aim of the present study was to compare the effects of a combination of gabapentin and paracetamol with gabapentin alone and placebo on post-operative pain and morphine consumption. METHODS: Seventy-five ASA I-II patients undergoing abdominal hysterectomy were included in the study and randomly divided into three groups. Placebo capsules (Group I, n = 25), 1200 mg of gabapentin (Group II, n = 25), or 1200 mg of gabapentin and 20 mg/kg paracetamol in combination (Group III, n = 25) were administered 1 h prior to surgery. Anaesthesia was standardized for all patients. Non-invasive arterial pressure, heart rate, respiratory rate, peripheral oxygen saturation, morphine consumption, nausea and vomiting, visual analogue scale-pain intensity scores (VAS-PI) and sedation scores were recorded at 1, 2, 4, 6 and 24 h following the operation. RESULTS: Morphine consumption at 24 h was 66.60 +/- 11.49 mg, 42.74 +/- 12.33 mg and 30.50 +/- 11.55 mg, respectively, in groups I, II and III (P < 0.05). Post-operative VAS-PI scores at movement and at rest were decreased with gabapentin and even more with a combination of gabapentin and paracetamol. Post-operative sedation scores were higher in groups II and III during the initial 4 h while these scores were higher in group I at 24 h. CONCLUSIONS: The single dose of gabapentin as well as a combination of gabapentin and paracetamol decreased the opioid requirement and increased the patients' satisfaction post-operatively.