Effect of fentanyl nasal packing treatment on patients with acute postoperative pain after closed reduction of nasal bone fracture: a randomized double-blind controlled trial

Abstract Background Sugammadex allows rapid recovery from rocuronium-induced neuromuscular blockade. Succinylcholine is often used for brief surgeries but is associated with myalgia, headache, histamine release, and increased lactate levels. Thus, we hypothesized that succinylcholine may affect emergence agitation (EA) and compared the effects of succinylcholine and rocuronium-sugammadex on EA in patients undergoing closed reduction of a nasal bone fracture under general anesthesia. Methods Forty-two patients were prospectively enrolled and allocated randomly to the succinylcholine group (group SC) or the rocuronium-sugammadex group (group RS; each n = 21). Neuromuscular block and its reversal were achieved with succinylcholine and normal saline in group SC, whereas rocuronium and sugammadex were administered in group RS. After surgery, the incidence of EA as a primary outcome, the incidence of dangerous EA, and duration of EA as secondary outcomes were compared. Results The incidence of EA was higher in group SC than in group RS (90.5% vs. 47.6%, respectively; relative risk [RR] 4.3; 95% confidence interval [CI] 1.2 to 15.7; P = .006). The incidence of dangerous EA increased in group SC compared to group RS (33.3% vs. 4.8%, respectively; RR 2.1; 95% CI 1.3 to 3.4; P = .045). The duration of agitation was longer in group SC than in group RS [106.5 (65.1) vs. 40.4 (26.0) sec; mean difference 66.1 s; 95% CI 31.0 to 101.1; effect size 1.3; P = .001). Conclusion Succinylcholine increases the incidence, severity, and duration of EA compared to rocuronium-sugammadex in patients undergoing closed reduction of a nasal bone fracture. Trial registration CRiS Registration number KCT0002673. Initial registration date was 31 January 2018 (Retrospectively registered).

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Prospective, double-blind, randomized trial evaluating subject pain, bleeding, and wound healing using biodegradable pure collagen sponge(Colladerm�) as endo-nasal packing materials in nasal bone fracture surgery.

Frontiers in Bioengineering and Biotechnology ◽

10.3389/conf.fbioe.2016.01.00446 ◽

2016 ◽

Vol 4 ◽

Author(s):

Choi Kangyoung ◽

Jung Gyusik ◽

Jo Inkook

Keyword(s):

Wound Healing ◽

Randomized Trial ◽

Bone Fracture ◽

Nasal Bone ◽

Collagen Sponge ◽

Nasal Packing ◽

Double Blind ◽

Packing Materials ◽

Pure Collagen ◽

Fracture Surgery

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Premedication with dexmedetomidine to reduce emergence agitation: a randomized controlled trial

10.21203/rs.2.9493/v4 ◽

2019 ◽

Author(s):

Jong Chan Kim ◽

Jihee Kim ◽

Hayeon Kwak ◽

So Woon Ahn

Keyword(s):

Randomized Controlled Trial ◽

Bone Fracture ◽

Closed Reduction ◽

Controlled Trial ◽

Nasal Bone ◽

Control Group ◽

Emergence Agitation ◽

Point Scale ◽

Randomized Controlled ◽

Scale Scores

Abstract Background: Nasal bone fracture is the most common type of facial fracture, and the high incidence of severe emergence agitation occurring after closed reduction of the nasal bone fracture can be challenging to manage. The purpose of this trial was to evaluate whether pre-operative administration of dexmedetomidine is effective in reducing the incidence and severity of emergence agitation in adults undergoing closed reduction of nasal bone fractures. Methods: In this randomized controlled trial, 90 patients who were scheduled to undergo closed reduction of a nasal bone fracture were prospectively included and were randomly assigned to either the control group (n = 45; 0.9% saline infusion) or the dexmedetomidine group (n = 45; 1 μ/kg over 10 min, pre-operatively). The primary endpoint was Aono's four-point scale scores after anesthesia. The recovery time and numeric rating scale score were assessed as secondary endpoints. Results: Aono's four-point scale scores were lower in the dexmedetomidine group than in the control group (median: 1 [1-1] vs. 1 [1-2], 95% confidence interval of difference: 0.01 to 0.02, P = 0.02). The number, severity, and duration of agitation episodes were significantly lower in the dexmedetomidine group than in the control group. Furthermore, the number of patients exhibiting intraoperative movement was lower in the dexmedetomidine group. Conclusions: Pre-operative administration of dexmedetomidine demonstrated several significant benefits, such as a lower incidence of emergence agitation, reduced agitation severity, and a shorter duration of agitation. Additionally, we observed more stable maintenance of intraoperative anesthesia with less movement during the surgery.

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