The Effect of Low-Dose of Propofol on the Respiratory Complications Immediately After Tracheal Extubation in Children Undergoing Tonsillectomy

2022 ◽  
Author(s):  
Habibollah Hosseini ◽  
Vida Ayatollahi ◽  
Ali Akbar Rahimianfar ◽  
Fatemeh Rahimianfar
Keyword(s):  
Low Dose ◽  
Tracheal Extubation ◽  
Respiratory Complications

Comparison of the Effects of Low Dose Methylprednisolone and Metoclopramide on Nausea and Vomiting and Respiratory Complications after Adenotonsillectomy

2021 ◽  
Vol 15 (9) ◽  
pp. 2753-2756
Author(s):  
Shahid Adalat Chaudhry ◽  
Madiha Zafar ◽  
Usman Zeeshan ◽  
Mubashar Iqbal ◽  
Arooj Fatima ◽  
...  
Keyword(s):  
Side Effects ◽  
Pain Score ◽  
Low Dose ◽  
Operative Time ◽  
Oral Intake ◽  
Respiratory Complications ◽  
Group I ◽  
Male Patients ◽  
Group Ii ◽  
Mean Time

Objective: The aim of this study is to compare the effects of low dose methylprednisolone and metoclopramide on nausea, vomiting and respiratory complications after adenotonsillectomy. Study Design: Retrospective study Place and Duration: The study was conducted in Divisional Headquarter Teaching Hospital, Mirpur AJK for duration of six months from December 2020 to May 2021. Methods: Total 150 patients of both genders underwent adenotonsillectomy presented in this study. Patients were aged between 3-15 years. Detailed demographics of enrolled cases age, sex and weight were recorded after taking informed written consent. Patients were equally divided into two groups. Group I had 75 patients and received 1 mg/kg IV methylpredinosolone and group II received 0.15 mg/kg metoclopramide among 75 patients. Post-operative effects on PONV were assessed and compared among both groups in terms of oral intake time, vomiting episodes, respiratory complications and side effects. Mean pain score was calculated by VAS. Complete data was analyzed by SPSS 23.0 version. Results: There were 40 (53.3%) females and 35 (46.7%) males in group I with mean age 9.43±1.44 years while in group II 42 (56%) were females and 33 (44%) were male patients with mean age 8.04±3.36 years. Mean weight of the patients in group I was 23.08±4.61 kg and in group II mean body weight was 22.11±6.84 kg. Mean operative time in group I was 27.41±8.53 min and in group II mean time was 28.17±6.34 min. Post-operative frequency of vomiting and nausea was lower in group I 14 (18.7%) and 16 (21.3%) as compared to group II 21 (28%) and 24 (34%). Low pain score was found in group I 1.71±6.11 as compared to group II 3.02±4.09. Time to oral intake was higher in group II 2.98±3.48 hours as compared to group I 1.09±7.51 hours. Rate of respiratory complications and side effects were significantly higher in group II. Conclusion: We concluded in this study that the use of methylpredinosolone was effective among patients those underwent for adenotonsillectomy in terms of post-operative frequency of PONV, pain, respiratory complications and side effects. Except this low dose of methylpredinosolone were effective in earlier tolerance of oral intake. Keywords: Adenotonsillectomy, Metoclopramide, Methylpredinosolone, Oral Intake

Early tracheal extubation after paediatric cardiac surgery: the use of propofol to supplement low-dose opioid anaesthesia

2001 ◽  
Vol 11 (4) ◽  
pp. 465-471 ◽  
Author(s):  
Steven H. Cray ◽  
Helen M. Holtby ◽  
Vyas M. Kartha ◽  
Peter N. Cox ◽  
W. Lawrence Roy
Keyword(s):  
Cardiac Surgery ◽  
Low Dose ◽  
Tracheal Extubation ◽  
Paediatric Cardiac Surgery

scholarly journals Comparison of the effects of low dose methylprednisolone and metoclopramide on nausea and vomiting and respiratory complications after adenotonsillectomy in children

2020 ◽  
Vol 24 (5) ◽  
Author(s):  
Ali Bestemi Kepekci ◽  
Bugra Subasi ◽  
Ahmet Hamdi Kepekci ◽  
Aziz Yarbil
Keyword(s):  
Low Dose ◽  
Oral Intake ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
High Rate ◽  
Late Period ◽  
Respiratory Complications ◽  
Analgesic Requirement ◽  
Pediatric Age Group ◽  
Significant Difference

Aim: Since tonsillectomies and/or adenoidectomies performed in the pediatric age group under general anesthesia have a high rate of postoperative nausea and vomiting (PONV), the practice of using prophylactic antiemetic drugs is common. This study aimed to compare the benefits of systemic administration of a low dose of inj. methylprednisolone 1 mg/kg with inj. metoclopramide 0.15 mg/kg IV for the prevention of PONV in children undergoing adenotonsillectomy. Methodology: In this study, the files of children undergone adenotonsillectomy from August 2015 to January 2018 in our hospital were analyzed retrospectively. 408 children aged 4-12 years were included in the study. Patients who were given methylprednisolone 1 mg/kg IV as premedication were placed in Group P, and patients who received metoclopramide 0.15 mg/kg were grouped as Group M. Effects on PONV, vomiting episodes, oral intake time, postoperative analgesic requirement, postoperative respiratory complications, and drug side effects were recorded. Results: Vomiting rates between 1-4 hrs (late period) were 11.0% in Group M (n = 22); It was 3.8% (n = 8) in Group P. In the late period, a significant difference was found between the two groups in terms of nausea and vomiting (p = 0.02, p = 0.07, respectively). In Group M, the incidence of respiratory complications was also higher in the postoperative period compared to Group P. Postoperative acetaminophen requirement increased significantly in group M compared to Group P (p = 0.006). Conclusion: Prophylactic use of a single dose of methylprednisolone 1 mg/kg IV during the preoperative period was more effective in reducing the incidence of late postoperative vomiting compared to metoclopramide and led to earlier tolerance of oral intake. In addition to its anti-inflammatory properties and antiemetic effects, low-dose methylprednisolone is also useful for prevention of respiratory complications. Key words: Methylprednisolone; Metoclopramide Hydrochloride; PONV; Respiratory complications; Tonsillectomy Citation: Kepekci AB, Subasi B, Kepekci AH, Yarbil A. Comparison of the effects of low dose methylprednisolone and metoclopramide on nausea and vomiting and respiratory complications after adenotonsillectomy in children. Anaesth. pain intensive care 2020;24(5): Received: 29 July 2020, Reviewed: 22 September 2020, Revised: 30 August 2020, Accepted: 2 October 2020

scholarly journals Effects of Reduction of the Caudal Morphine Dose in Paediatric Circumcision on Quality of Postoperative Analgesia and Morphine-Related Side-Effects

2007 ◽  
Vol 35 (5) ◽  
pp. 743-747 ◽  
Author(s):  
M. Cesur ◽  
H. A. Alici ◽  
A. F. Erdem ◽  
T. Yapanoglu ◽  
F. Silbir
Keyword(s):  
Side Effects ◽  
Epidural Morphine ◽  
Low Dose ◽  
Low Doses ◽  
Respiratory Complications ◽  
Rescue Analgesia ◽  
Morphine Dose ◽  
To Receive ◽  
Caudal Epidural

This study compared the efficacy and adverse effects of three low doses of morphine (10, 15 and 30 μg.kg1) for caudal epidural analgesia in children undergoing circumcision. A total of 135 boys undergoing outpatient circumcision were randomly assigned to receive 10, 15 or 30 μg.kg1 of caudal morphine. Anaesthesia was induced and maintained with propofol. After induction, the morphine was added to 0.5 ml.kg1 1% lignocaine solution with adrenaline 5μg.ml1 and injected caudally. Anaesthesia quality, postoperative pain and adverse events in a 24-hour period were evaluated. Paracetamol (20 mg. kg’ orally) was used as rescue analgesia as required. No patient required paracetamol in the first eight hours after the caudal injections. In the first 24 hours postoperatively no further analgesia was required in 66.7%, 77.8% and 91.1% of the patients in the 10, 15 and 30 μg.kg1 groups, respectively (P=0.01 for 10 vs. 30 groups). All patients had excellent analgesia. No respiratory complications were observed. Nausea-vomiting occurred in 13.3%, 20% and 46.7% of the patients in the 10, 15 and 30 μg.kg1 groups (P=0.002 for 10 vs. 30 and 0.044 for 15 vs. 30). Pruritus occurred in 8.9%, 11% and 15.6% in the 10, 15 and 30 μg.kg1 groups but was localised and did not require treatment. This study was not powered to assess concerns that low dose epidural morphine may rarely be associated with delayed apnoea and is therefore considered unsuitable for outpatient use in many centres. Increases in caudal morphine dose above 10 μxg. kg1 produce some ‘paracetamol sparing’ but no improvement in analgesia, some pruritus and a significant increase in nausea and vomiting.

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