Premedication With Midazolam or Haloperidol to Prevent Recovery Agitation in Adults Undergoing Procedural Sedation With Ketamine: A Randomized Double-Blind Clinical Trial

Akhlaghi, Narjes; Payandemehr, Pooya; Yaseri, Mehdi; Akhlaghi, Ali Asghar; Abdolrazaghnejad, Ali

doi:10.1016/j.annemergmed.2018.11.016

Cited by 30 publications

(35 citation statements)

References 18 publications

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“…In some studies, in Europe and the United States, recovery agitation has been estimated approximately 15% to 20% and in Turkey and India approximately 25% and 30%, respectively. [ 4 9 13 14 ] In many previous studies, it was not clear which symptoms were known as agitation. Some studies have identified recovery agitation based on patient's dreams and experiences or observations made by researchers during sedation and recovery, none of which are objective.…”

Section: Discussionmentioning

confidence: 99%

“…Sedation level was assessed using Richmond Agitation–Sedation Scale (RASS) [ Table 1 ]. [ 9 ] The RASS was assessed every 5 min until the end of the procedure. Additional doses of ketamine 0.25 mg/kg IV bolus were administered when RASS was more than − 4 (deep sedation) at any moment during the procedure in each group.…”

Section: Methodsmentioning

confidence: 99%

“…Numerous studies have been tried to compare different drugs such as midazolam, dexmedetomidine (Dex), propofol, clonidine, and haloperidol to reduce these adverse responses. [ 8 9 10 ]…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the effects of dexmedetomidine and propofol in reducing recovery agitation in pediatric patients after ketamine procedural sedation in emergency department

et al. 2021

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Background: Ketamine has been a safe and effective sedative agent commonly used for painful pediatric procedures in the emergency department (ED). This study aimed to compare the effect of dexmedetomidine (Dex) and propofol when used as co-administration with ketamine on recovery agitation in children who underwent procedural sedation. Materials and Methods: In this prospective, randomized, and double-blind clinical trial, 93 children aged between 3 and 17 years with American Society of Anesthesiologists Class I and II undergoing short procedures in the ED were enrolled and assigned into three equal groups to receive either ketadex (Dex 0.7 μg/kg and ketamine 1 mg/kg), ketofol (propofol 0.5 mg/kg and ketamine 0.5 mg/kg), or ketamine alone (ketamine1 mg/kg) intravenously. Incidence and severity of recovery agitation were evaluated using the Richmond Agitation-Sedation Scale and compared between the groups. Results: There was no statistically significant difference between the three groups with respect to age, gender, and weight ( P > 0.05). The incidence of recovery agitation was 3.2% in the ketadex group, 22.6% in the ketofol group, and 22.6% in the ketamine group ( P = 0.002, children undergoing short procedures were recruited). There was a less unpleasant recovery reaction (hallucination, crying, and nightmares) in the ketadex group compared with the ketofol and ketamine groups ( P < 0.05). There was no difference in the incidence of oxygen desaturation between the groups ( P = 0.30). Conclusion: The co-administering of Dex to ketamine could significantly reduce the incidence and severity of recovery agitation in children sedated in the ED.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Comparison of the effects of dexmedetomidine and propofol in reducing recovery agitation in pediatric patients after ketamine procedural sedation in emergency department

et al. 2021

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“…Another cross sectional observational study conducted by Lohit etal also concluded that perioperative administration of midazolam with ketamine was found to be effective in controlling EP, leading to a smooth postsurgical recovery [90]. Another recent RCT published in 2019 also concluded that premedication with either midazolam 0.05 mg/kg or haloperidol 5 mg intravenously significantly reduces ketamine-induced recovery agitation while delaying recovery [91].…”

Section: Ketamine and Emergence Reactionsmentioning

confidence: 99%

Comeback of ketamine: resurfacing facts and dispelling myths

Kumar

Kohli

2021

Korean J Anesthesiol

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Initially known as CI-581, ketamine was first synthesized in 1962 as a replacement for phencyclidine (PCP). It is being used since then as a profound anesthetic and analgesic, in addition has bronchodilating, sedative and amnestic properties with the preservation of airway reflexes and sympathetic nervous system tone. Ketamine is always a stimulating topic of discussion since its discovery as the controversies regarding its usage in certain set of patients mostly overpowers its boon. In past 50 years, despite of potential benefits it has not gained acceptable popularity because of concerns of "emergence phenomenon", its use as substance of abuse and systemic side effects. Since 2012, ketamine has been subject to three World Health Organization (WHO) reviews addressing its international control. Researchers are widely studying this wonder drug since a decade worldwide. Many myths of ketamine regarding emergence phenomenon, its use in traumatic brain injury, open eye injury is getting busted in recent times. It's again getting popular in pre-hospital settings, critical care, emergency medicine, low dose acute pain services & adjuvant in regional anesthesia techniques. This review will highlight the current consensus on the various applications of ketamine in the light of available evidence in the literature.

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“…(2019) The flu virus binds to a sugar in human cells called sialic acid. Tamiflu is a drug that inhibits the ability of the flu to bind to these sugars, and is an excellent example of how the interaction of noramine (an acidic amino sugar in the blood) helps identify an effective antiviral drug [27][28][29].…”

Section: Introductionmentioning

confidence: 99%

Untitled

2021

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The aim of this study was to investigate the relationship between ABO blood groups and the rate and severity of morbidity and mortality in patients with Covid-19 in Zahedan. The present study is a descriptive-analytical study and includes a sample of 349 patients with Covid-19 referred to hospitals in Zahedan from March 2016 to August 2017. The sampling method was census and for data collection, case studies and checklists were used. The data were analyzed by Chi-square test through SPSS software. Among the 328 patients, 132(41%) had blood type O, 92(28%) had blood type A, 80(24%) had blood group B and 24(7%) had AB blood type. There was no significant relationship between blood groups and age (P <0.150). Patients in the age group of 30-60 years with 208 (63.4%) had the highest number, of whom 78 (23.8%) had blood type O. There was a significant relationship between blood groups and gender (P = 0.001), so male patients with 178 (54.3%) were more, of whom 72 (22%) had blood type O. There was no significant relationship between blood groups and place of hospitalization (P <0.121); however, inpatient department patients with 150 (45.7%) had the highest number, of whom 62 (41.3%) had blood type O. There was no significant relationship between blood groups and severity of covid-19 (P <0.121); however, patients with moderate severity had the highest number with 150 (45.7%) patients, of whom 62 (41.3%) had blood type O.

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Premedication With Midazolam or Haloperidol to Prevent Recovery Agitation in Adults Undergoing Procedural Sedation With Ketamine: A Randomized Double-Blind Clinical Trial

Cited by 30 publications

References 18 publications

Comparison of the effects of dexmedetomidine and propofol in reducing recovery agitation in pediatric patients after ketamine procedural sedation in emergency department

Comparison of the effects of dexmedetomidine and propofol in reducing recovery agitation in pediatric patients after ketamine procedural sedation in emergency department

Comeback of ketamine: resurfacing facts and dispelling myths

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