Comparison of Haloperidol versus Midazolam for Prevention of Sevoflurane Emergence Agitation in Pediatric patients undergoing Inguinal Surgeries

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Dalia Tarek Ali Ahmed El-Shahawy ◽  
Mohamed Sidky Mahmoud Zaki ◽  
Dalia Ahmed Ibrahim ◽  
Ahmed Mohammed El Sayed
Keyword(s):  
Pediatric Patients ◽  
Randomized Study ◽  
Emergence Agitation ◽  
Caudal Block ◽  
Physical Status ◽  
Significant Delay ◽  
University Hospitals ◽  
Institutional Ethics ◽  
Eye Opening ◽  
Postoperative Problem

Abstract Background Emergence agitation (EA) in children early after sevoflurane anaesthesia is a common postoperative problem, with incidence ranging up to 80%, It is characterized by behavior that can include crying, disorientation, excitation and delirium, several drugs have been tried in this regard including but not limited to propofol, midazolam, ketamine and ketorolac among other drugs. Aim of the Work To compare the effect of intravenous Midazolam vs intravenous Haloperidol & in prevention of Sevoflurane Emergence Agitation in pediatric patients undergoing Inguinal Surgeries. Patients and Methods This prospective randomized study was done after approval of institutional ethics committee in Ain Shams university Hospitals for 6 months and obtaining an informed written consent from parents. It was designed to include sixty-two pediatric patients, aged 3 to 12 years of both genders, with physical status ASA Ι and ASA ІІ. All surgical procedures were elective of an expected duration of 30 - 60 minutes e.g. inguinal hernia repair, hydrocele, orcheopexy under general anesthesia and caudal block to relief pain. All operations were performed in supine position. Results Our study was applied on age group between 3- 12 years old Haloperidol was associated with 24% EA and was also associated with significant delay in eye opening and time till discharge from PACU when compared to Midazolam. Conclusion I.V Midazolam is more efficient than I.V Haloperidol for prevention of Sevoflurane Emergence agitation in pediatric patients undergoing inguinal surgeries.

A comparison of intranasal dexmeditomidine versus intranasal midazolam as a pre anesthetic medication in children undergoing adenotonsillectomy

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Nourhan M El Zoghby ◽  
Ahmed S Mohammed ◽  
Ahmed M El Hennawy ◽  
Ramy M Wahba
Keyword(s):  
Pediatric Patients ◽  
Controlled Clinical Trial ◽  
Physical Status ◽  
University Hospitals ◽  
Double Blind ◽  
Institutional Ethics ◽  
Pediatric Anesthesiologist ◽  
Important Concern ◽  
Anxiety Levels ◽  
Intranasal Midazolam

Abstract Background Adenotonsillectomy is one of the most common surgical procedures performed on pediatric patients. Relieving pre- and post-operative anxiety is an important concern for the pediatric anesthesiologist. Aim of the Work: to compare dexmedetomidine with midazolam effect on preoperative sedation, the ease of children parent separation, the mask tolerance, intraoperative hemodynamics stability, emergence of anesthesia and postoperative analgesia. Patients and Methods A Prospective, randomized and double blind controlled clinical trial was done after approval of institutional ethics committee in Ain Shams university Hospitals for 6 months and obtaining an informed written consent from parents. It was designed to include fifty pediatric patients, aged 5 to 10 years old of both genders, with physical status ASA Ι. Results statistically significant increase mean of Dexmedetomidine compared to midazolam according to sedation score after 15min. to after 45min. Conclusion Premedication with intranasal dexmedetomidine 1 μg/kg attained significant and satisfactory sedation with better parent separation and lower anxiety levels without any adverse effects as compared with intranasal midazolam 0.2 mg/kg in children undergoing adenotonsillectomy.

scholarly journals The Analgesic Efficacy of Ultrasound-Guided Quadratus Lumborum Block Versus Ultrasound-Guided Caudal Block for Hip Surgery in Pediatrics: A Prospective Randomized Study

2021 ◽  
pp. 58-68
Author(s):  
Islam M. Salim ◽  
Shimaa M. EL. Rahwan ◽  
Mohamed M. Abu Elyazd ◽  
Lobna M. Abo Elnasr
Keyword(s):  
General Anesthesia ◽  
Pediatric Patients ◽  
Randomized Study ◽  
Analgesic Efficacy ◽  
Surgical Correction ◽  
Nausea And Vomiting ◽  
Block Group ◽  
Caudal Block ◽  
Ultrasound Guided ◽  
Quadratus Lumborum

Background: Ultrasound-guided quadratus lumborum (QL) block, is local anesthetic technique providing perioperative somatic, perhaps even visceral, analgesia for patients of all ages. The aim of this study is to evaluate the analgesic efficacy of ultrasound-guided anterior QL block versus ultrasound-guided caudal block in pediatric patients undergoing hip surgery. Patients and Methods: This prospective, randomized study was carried out on seventy patients aged 1-7 years, of both with ASA physical status I or II scheduled for elective surgical correction of developmental dysplasia of hip (DDH). Anterior QL Block Group: Patients received ipsilateral ultrasound-guided anterior QL block after induction of general anesthesia using of bupivacaine 0.25% (0.5 mL/kg). Caudal Block Group: Patients received ultrasound-guided caudal block after induction of general anesthesia using of bupivacaine 0.25% (0.75 mL/kg). Postoperative pain scores were assessed on admission to PACU and at 1, 2, 4, 6, 8, 12, 18 and 24 h postoperative. Total intraoperative fentanyl (µg) consumption, total postoperative rescue analgesic (morphine) consumption, time to the first rescue analgesic administration and Parent satisfaction were assessed. Heart rate and mean arterial blood pressure had been recorded pre–operative, every 15 min intra-operative , and postoperative on admission to PACU and at 1, 2, 4, 6, 8, 12, 18 and 24 h postoperative. Any undesirable side effects during the first 24 hours such as, bradycardia, hypotension, local hematoma at the side of injection, nausea and vomiting had been recorded. Results: The median FLACC score was significantly lower in anterior QL block group than caudal block group at 4,6,8 and 12h postoperative (P<0.001). Total intraoperative fentanyl (µg) consumption was insignificant different between both groups (P=0.862). Post-operative morphine consumption was significantly lower in anterior QL group compared to caudal group (P<0.001). Time to first postoperative analgesic requirement was significantly prolonged in anterior QL block group compared to caudal block group (P < 0.001). The incidence of nausea and vomiting was insignificantly different between both groups (P > 0.999). Conclusions: Ultrasound-guided anterior QL block provided effective and long lasting postoperative analgesia than ultrasound-guided caudal block with lesser postoperative analgesic consumption in pediatric patients undergoing surgical correction of DDH.

scholarly journals Caudal block versus penile block for postoperative analgesia in children undergoing hypospadias repair

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H G Salama ◽  
M H Elsersi ◽  
T S Shabana ◽  
J M Mahanna
Keyword(s):  
Postoperative Analgesia ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Randomized Study ◽  
Hypospadias Repair ◽  
Caudal Block ◽  
Analgesic Requirement ◽  
Analgesic Regimen ◽  
Significant Difference ◽  
Penile Block

Abstract Background Hypospadias repair is one of the most frequently performed surgical procedures in the pediatric population. Using optimal analgesic regimen provides safe and effective analgesia, reduce postoperative stress response and accelerate recovery from surgery. Aim of the Work The aim of this work is to evaluate the success rate and the effectiveness of penile block for hypospadias repair in pediatric patients in comparison with caudal block. Patients and Methods This prospective randomized study was conducted in Ain Shams University Hospitals; Pediatric Surgery Unit. It included 80 ASA I or II patients undergoing hypospadias (distal penile and mid penile) repair. They were divided into two groups: Group P: Group P penile block (n = 40) received dorsal penile nerve block by using the subpubic approach technique. Group C: Group C caudal block (n = 40) received caudal epidural block using a 22-G needle in the lateral decubitus position. Results There was no statistically significant difference between two groups regarding haemodynamics including MBP (P &lt; 0.05) and HR (P &lt; 0.05). FLACC pain scores were significantly lower in group C compared with group P (P&lt; 0.01). Also, the time to first need for analgesia was significantly lower in group C compared with group P (P&lt; 0.001) .The total rescue analgesic requirement was also significantly lower (P&lt; 0.001) in group C compared with group P.Postoperative time of ambulation was also significantly lower (P&lt; 0.05) in group P compared with group C. Conclusion the current study revealed that caudal block provided significantly prolonged postoperative analgesia, reduced the postoperative analgesic requirements and prolonged time of ambulation as compared with penile block in pediatric patients undergoing hypospadias repair.

scholarly journals Caudal block with 3 mg/Kg Bupivacaine for intraabdominal surgery in pediatric patients: a randomized study

2011 ◽  
Vol 5 (1) ◽  
pp. 93-99 ◽  
Author(s):  
Witthaya Loetwiriyakul ◽  
Thanyamon Asampinwat ◽  
Panthila Rujirojindakul ◽  
Mayuree Vasinanukorn ◽  
Tee Chularojmontri ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Pediatric Patients ◽  
Randomized Study ◽  
Volatile Anesthetic ◽  
Caudal Block ◽  
Adequate Dose ◽  
Group A ◽  
Group B ◽  
Double Blinded ◽  
To Receive

Abstract Background: Caudal block with the use of an adequate dose of bupivacaine, and combined with a general anesthesia (GA) provides intra-operative anesthesia and postoperative analgesia. No study has examined the use of 3 mg/Kg bupivacaine for intra-abdominal surgery in pediatric patients in clinical practice. Objective: Compare the effectiveness of three mg/Kg bupivacaine administered as 1.2 mL/Kg 0.25% bupivacaine and 1.5 mL/Kg 0.2% bupivacaine for caudal block in pediatric patients undergoing intra-abdominal surgery. Methods: In a randomized, double-blinded clinical trial, patients (age: 6 months -7 years) were randomly assigned into one of two groups (n= 40) to receive a caudal block with either 1.2 mL/Kg 0.25% bupivacaine (group A) or 1.5 mL/Kg 0.2% bupivacaine (group B), with morphine 50 μg/Kg. The effectiveness of intra-operative anesthesia, complications, and requirements for post-operative analgesia were evaluated. Results: Data were available for 74 pediatric patients. There were no significant differences between the two groups in baseline characteristics. Intra-operatively, the numbers of patients who required a rescue analgesic were comparable between the groups (67% in group A and 63% in group B). The numbers of patients who required a muscle relaxant were also comparable between groups (49% in group A and 57% in group B). The time from discontinuation of the volatile anesthetic to extubation was significantly shorter in group B (9.5±1.1 minutes) than group A (14.3±0.9 minutes), p < 0.01. The time from initial caudal block to the first analgesic required in the recovery room was significantly longer in group B (202±45 minutes) than in group A (149±27 minutes). The time from the caudal block to the first analgesic required in the ward was significantly longer in group B (10.4±3.1 hours) than in group A (8.2±2.0 hours). Overall fentanyl requirements were comparable between groups, 52.5±2.0 μg in group A and 49.5±3.0 μg in group B. Conclusion: Caudal block by either 1.2 mL/Kg 0.25% bupivacaine plus morphine 50 μg/Kg or 1.5 mL/Kg 0.2% bupivacaine plus morphine 50 μg/Kg provided effectively equivalent intra-operative analgesia and surgical relaxation. However, a caudal block with 1.5 mL/Kg 0.2% bupivacaine plus morphine 50 μg/Kg provided superior prolonged analgesic advantages compared with 1.2 mL/Kg 0.25% bupivacaine plus morphine 50 μg/Kg in pediatric patients undergoing intra-abdominal surgery.

Sugammadex for reversal of neuromuscular blockade in pediatric patients: results from a phase IV randomized study

2021 ◽  
Author(s):  
Tiffini Voss ◽  
Aobo Wang ◽  
Matthew DeAngelis ◽  
Marcel Speek ◽  
Vera Saldien ◽  
...  
Keyword(s):  
Neuromuscular Blockade ◽  
Pediatric Patients ◽  
Randomized Study ◽  
Phase Iv

Validation of Bench Training Model for Cleft Palate Surgery

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Karim Samir Masoud ◽  
Mohamed Abdel Mohsen Ghanem ◽  
Ahmed Sobhi Hweidi ◽  
Ahmed Mostafa El Sayed Zidane
Keyword(s):  
Cleft Palate ◽  
Training Model ◽  
Single Session ◽  
University Hospitals ◽  
Training Tool ◽  
Institutional Ethics ◽  
Operating Theatres ◽  
Training Of Surgeons ◽  
Effective Use ◽  
Bench Model

Abstract Background Cleft palate is one of the most common congenital malformations worldwide. It can be non-syndromic or it can appear as a part of a syndrome or recurrence pattern. Aim of the Work To provide a valid life-size realistic training model of cleft palate surgery that aids in pre-operative training of residents and improvement of their skills in life surgery. Patients and Methods This interventional pilot study was done after approval of institutional ethics committee in Ain Shams University Hospitals operating theatres and in plastic surgery department’s skill lab for 6 months and obtaining an informed written consent from parents. It was designed to develop a bench model of cleft palate for pre-operative training of surgeons and assess its validity. Results In our study we found that the performance of trainees after using our developed bench model of cleft palate shows statistically significant improvement according to GRITS score by 63.2% compared to those who proceeded to live cases directly without training Conclusion This study further demonstrates the effective use of a novel cleft palate bench model as a training tool. After a single session, we observed improvement in cleft palate procedural skills, confidence, knowledge and time taken to finish the operation among trainees both with and without previous cleft experience. Additional research is needed to assess the durability of these improvements over time, and also the benefit of additional sessions with the bench model.

Sign in / Sign up

Export Citation Format

Share Document