Background Use of muscle relaxants for tracheal intubation in pediatric patients been associated with significant side effects and complications during general anesthesia. Many anesthetic drug combinations have been used to facilitate intubation without the use of relaxants. Objectives To compare the efficacy of three different doses of Propofol to obtain optimum intubating conditions. Patients and Methods One hundred and four pediatric patients enrolled in our study after ethical committee approval and written parental consent. Patients were belonging to the American Society of Anesthesiologist physical status classes (I and II), aged from 18 months to 5 years, and were scheduled for tonsillectomy and/or adenoidectomy. Patients were pre-medicated with midazolam 0.2 mg/kg and ketamine 3 mg/kg 15-30 minutes before induction orally. Patients were randomly divided into 4 groups: Group I (control group) did not receive Propofol, while Group II, Group III, and Group IV received (1, 2 and 3 mg/kg of intravenous Propofol respectively). Cough, movement of the limb, tachycardia and smooth intubation condition had been recorded during intubation. Results Cough, movement of the limbs, tachycardia were mostly reported among the control group (100%, 74%, 43%) respectively. While smooth intubation condition was mostly among the group IV. 1mg/kg Propofol abolished cough response. 2mg/kg Propofol abolished movement of the limbs. 3 mg/kg Propofol was superior to 2 mg/kg Propofol in decreasing tachycardia response and smooth intubation condition. Conclusion Propofol in a dose of 3 mg/Kg I.V. is an excellent adjuvant drug for smooth intubation in children anesthetized with Sevoflurane.
Propofol is commonly used intravenous anesthesia induction drug but it causes ache upon use, many method with different results, have been suggested to prevent this pain, the current research was concluded in order to investigate the impact of lidocaine, ketamine in reducing the ache on giving intravenous propofol. This study is randomized controlled clinical trial lasting from June 2015 to November 2015 during which 107 consenting (ASA1 and ASA2) patients were prepared for elective operation with general anesthesia. They randomly split to three subgroups, A cannula (size20) used in the dorsum hand veins, standard monitor was established patients received either 2mL (40 mg) of lidocaine or 2mL (20mg) of ketamine and 2 mL of saline 1 min before injection 2.5 milligram per kilogram propofol. ache severity observed by using four number pain scale, zero = none, one= mild pain, two = moderate pain, and three = intense pain. Atracurium used for indotracheal intubation, isoflurane and fentanyl for anesthesia maintenance. There were no variations between the study groups regarding ASA status, Sex, age. The incidence of ache when injecting propofol were observed in the normal saline group was 86.5% and it was more than ketamine group 0% and lidocaine group 20%Kurdistan Journal of Applied Research | Volume 4 -Issue 2 -December 2019 | 235 (p=0.0002). In the normal saline pretreatment group 8.1% of the patient experienced severe pain, compared with 0% in the lidocaine and ketamine. It can be concluded that intravenous ketamine and lidocaine were equally effective in preventing Ache during propofol injection.
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