Objective: We aimed to investigate the effects of dexmedetomidine premedication before intravenous infusion of ketamine in agitated children undergoing strabismus surgery. Subjects and Methods: We enrolled 60 agitated pediatric patients, aged 4.5–11 years. The patients were randomly allocated to one of two anesthesia regimens. Group D patients were premedicated with a single dose of intravenous dexmedetomidine 0.5 µg/kg whereas group P patients received a placebo. Patients in both groups were administered intravenous ketamine 1 mg/kg i.v. over 1 min followed by a continuous infusion of ketamine 1–3 mg/kg/h i.v. (n = 30). Patients were intubated after receiving fentanyl 1 µg/kg and rocuronium bromide 0.5 mg/kg. Results: 21 (70%) patients in group D did not show the oculocardiac reflex (OCR) versus 7 (23%) in group P (p = 0.0006). The preoperative and postoperative agitation scores (p = 0.0001 and p = 0.03, respectively), the score on the Faces Pain Scale during awakening [3.0 (interquartile range, IQR 2.0–4.0) in group D and 0.0 (IQR 1.0–2.25) in group P] (p = 0.001) and at the 60th postoperative minute [IQR 2.0 (1.5–3.0) in group D and 2.0 (IQR 1.5–3.0) in group P] (p = 0.004), sore throat (26.6% in group D and 60% in group P) (p = 0.01) and analgesic requirement (20% in group D and 53% in group P) (p = 0.01) in group P were significantly higher than in group D. The Ramsay Sedation Score (RSS) in group D was significantly higher than in group P during awakening [2.0 (2.0–2.0) in group D and 4.5 (4.0–5.0) in group P] (p = 0.0001). Conclusion: Dexmedetomidine premedication followed by intravenous infusion of ketamine was effective in decreasing OCR, agitation, pain, analgesic requirement in agitated children undergoing strabismus surgery.
To compare the effects of intravenous infusion of ketamine and propofol anesthesia in children undergoing strabismus surgery. Methods: Sixty pediatric patients aged 4-11 years were enrolled for the study. Patients in Group K were infused ketamine 1-3 mg/kg/hr (n = 30) and patients in Group P were infused with propofol 6-9 mg/kg/hr (n = 30). After giving fentanyl 1 µg/kg and rocuronium bromide 0.5 mg/kg, patients were intubated. Results: The consumption of anesthetics (P = 0.0001) and antiemetics (P = 0.004), the incidence of oculocardiac reflex (P = 0.02) in Group K were significantly lower than in Group P. The recovery time (P = 0.008), postoperative agitation score (P = 0.005), Face Pain Scale (P = 0.001), Ramsay Sedation Score (P = 0.01) during awakening and at postoperative 30th min (P = 0.02) in Group K were significantly lower than in Group P. The postoperative agitation score during awakening was significantly lower than the preoperative values in Group K (P = 0.0001). Conclusions: The infusion of ketamine is more advantageous than the infusion of propofol in children for use in strabismus surgery.
Objectives:Trigeminal neuralgia (TN) has been effectively treated by radiofrequency thermocoagulation (RFT) of the gasserian ganglion. Recently, pulsed radiofrequency (PRF) is becoming an alternative therapy for patients with trigeminal neuralgia. It is unclear whether the combination of RFT with PRF may decrease post-operative complications while maintaining longterm pain relief. Methods: Twelve patients with idiopathic TN who had undergone combined RFT and PRF of the gasserian ganglion were evaluated. PRF (42 °C, 45V, 20 ms, 120 seconds) was administered, and then RFT (65 °C, 90 seconds) was performed to the gasserian ganglion. The post-operative pain relief and complications were evaluated at 1, 6, 12 and, 24 months after treatment. Results: 10 patients (83.3%) reported significant pain relief (VAS 3) at 1 month following the treatment, while 8 patients (66.6%) at 6 months, 5 patients (41.6) at 12 months, and 2 patients (16.6%) at 24 months were pain-free. Two of the patients did not have pain relief (VAS ≥3), and 2 patients were still pain-free by the 24 th month. The mean time of pain relief was 14 months. One patient had numbness in the tongue for about a year, while in the other patients, no serious complications were reported. Conclusion: A combination of RFT with PRF could help eliminate postoperative complications of trigeminal neuralgia. We sugesst that combining RFT and PRF therapy may serve to decrease the side effects but not increase the pain relief. ÖzetAmaç: Trigeminal nevralji (TN), gasserian ganglionun radyofrekans termokoagülasyonu (RFT) ile etkin bir şekilde tedavi edilmiştir. Son zamanlarda, pulse radyofrekans (PRF) trigeminal nevraljisi olan hastalar için alternatif bir tedavi haline gelmektedir. RFT ile PRF kombinasyonunun postoperatif komplikasyonları azaltıp azaltmadığı ve uzun süreli ağrıların giderilip giderilmediği belirsizdir. Gereç ve Yöntem: Gasser ganglionun kombine RFT ve PRF'si uygulanan idiopatik TN'lı 12 hasta değerlendirildi. PRF (42 °C, 45 V, 20 ms, 120 saniye) uygulandı ve daha sonra, Gasser gangliona RFT (65 °C, 90 saniye) yapıldı. Postoperatif ağrı rahatlaması ve komplikasyonları tedaviden 1, 6, 12 ve 24 ay sonra değerlendirildi. Ağrı için VAS 3 ve üzeri dikkate alındı. Bulgular: 10 hastada (%83.3) tedaviden 1 ay sonra ağrıda belirgin azalma varken, 6. ayda 8 hasta (%66.6), 12. ayda 5 hasta (%41.6) ve 24. ayda 2 hasta (%16.6) ağrısızdı. Hastaların 2'sinde ağrı rahatlaması yoktu (NRS ≥3) ve 24. ayda 2 hasta hala ağrısızdı. Ağrı rahatlama süresi ortalama 14 aydı. Bir hastada yaklaşık bir yıldır dilde uyuşma vardı, diğer hastalarda ise ciddi komplikasyonlar bildirilmedi. Sonuç: PRF ile RFT kombinasyonu, trigeminal nevraljinin postoperatif komplikasyonlarını ortadan kaldırabilir. RFT ve PRF tedavisini kombine etmenin yan etkilerin azaltılmasına hizmet edebileceğini ancak ağrıyı azaltmadığını belirtmek isteriz.Anahtar sözcükler: Gasser ganglion blokajı; pulse radyofrekans; radyofrekans termokoagülasyon; trigerminal nevralji.
Transforaminal epidural steroid enjeksiyonu radiküler ağrı tedavisi için kullanılan yaygın bir girişimdir. Komplikasyonları nadir fakat katastrofiktir. En nadir katastrofik komplikasyonlarından biri Adamkiewicz arter (AKA) oklüzyonu ile ilgilidir. Bu sunumda transforaminal epidural steroid enjeksiyonu ile ilişkili AKA injurisinden kaçınmak için uyguladığımız yaklaşımı sunduk. 71 yaşında erkek hasta kliniğimize lomber disk hernisine bağlı radikülopati ile başvurdu. Hastaya transforaminal steroid enjeksiyonu planlandı. Radyokontrast enjeksiyonu sonrasında vasküler dolum görüldü. Bunun üzerine iğneye yeniden pozisyon verilerek epidural alana ulaşmak için inferior giriş uygulandı. Vasküler yayılım görülmedi ve dexametazon enjekte edildi. Transforaminal epidural enjeksiyon radiküler ağrı için efektif bir girişimsel ağrı tedavisidir. Fakat muhtemel katastrofik komplikasyonlar nedeniyle dikkatli olmayı gerektirir. AKA büyük oranda foramenin üst yarısında lokalizedir. Spinal kord iskemisini önlemek için AKA'nın çok geniş bir anatomik varyasyona sahip olduğunu akılda bulundurmak çok önemlidir.Anahtar sözcükler: Adamkiewicz arteri; infranöral yaklaşım, spinal kord iskemisi; transforaminal epidural enjeksiyon.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.