scholarly journals Comparing the effects of propofol and ketamine on the emergence agitation of male children undergoing circumcision

2022 ◽  
Vol 18 (1) ◽  
Author(s):  
Ayşenur Sümer Coşkun
Keyword(s):  
Anesthesia Care ◽  
Post Anesthesia Care Unit ◽  
Emergence Agitation ◽  
Point Scale ◽  
Bodily Integrity ◽  
Inhalational Anesthesia ◽  
Significant Difference ◽  
The Family ◽  
Safe Anesthesia ◽  
Made In

Abstract Background Separation from the family, prolonged hunger, inability to perceive the surgical procedure performed, and feeling pain are among the main reasons for agitation in young children. In operations like circumcision, in which all bodily integrity is disrupted and children cannot make sense of it and feel punished, this agitation increases. The aim of the present study was to compare the effects of propofol and ketamine on the emergence agitation (EA) in children undergoing circumcision. Result When the patients were taken to post-anesthesia care unit (PACU), no statistically significant difference was observed between propofol and ketamine groups in the Aono’s four-point scale at minute 0 (p = 0.073). In the 5th minute, it was higher in the ketamine group compared to the propofol group (p < 0.001). With Aono’s four-point scale, EA diagnosis is made in areas with 3 and 4 points. The average Aono’s four-point scale in the ketamine group at the 5th minute was 3.08 ± 1.02. Since the Modified Steward score was ≥ 6, the time taken was longer in the ketamine group compared to the propofol group (p < 0.001). Conclusion EA does not only occur in inhalational anesthetics, it is also seen with ketamine. In view of the fact that ketamine can cause EA in children, it should not be used alone in anesthesia. Propofol provides a safe anesthesia. Instead of inhalational anesthesia, where the type of surgery is suitable, anesthesia with propofol infusion should be applied. Further research is required to investigate EA.

Emergence Agitation

2013 ◽  
Author(s):  
Charles B Eastwood ◽  
Paul J Samuels
Keyword(s):  
Patient Safety ◽  
Pediatric Anesthesia ◽  
Medication Administration ◽  
Parental Satisfaction ◽  
Anesthesia Care ◽  
Post Anesthesia Care Unit ◽  
Emergence Agitation ◽  
Urinary Catheters ◽  
Emergence Delirium ◽  
Present Understanding

Emergence delirium is a common and challenging post-anesthetic complication in children characterized by a brief period of inconsolability, disorientation, and combativeness. Emergence delirium threatens patient safety due to potential self-injurious behavior or by untimely removal of intravenous lines, urinary catheters, and surgical drains. The economic impact of emergence delirium is a consequence of delayed post-anesthesia care unit (PACU) discharge and the need for additional medication administration and increased PACU staffing. In addition, despite the short duration of emergence delirium, its dramatic and frightening presentation can diminish parental satisfaction. Although no consistently effective treatment for emergence delirium has been described, familiarity with this clinical entity and approaches to its management and prevention are important to those who provide pediatric anesthesia care. This chapter will focus on our present understanding of emergence delirium in children.

Capnography Monitoring to Reduce Adverse Events in the Pediatric Post-Anesthesia Care Unit

PEDIATRICS ◽  
2016 ◽  
Vol 137 (Supplement 3) ◽  
pp. 189A-189A
Author(s):  
Melissa L. Langhan ◽  
Fangyong Li ◽  
Lance Lichtor
Keyword(s):  
Adverse Events ◽  
Anesthesia Care ◽  
Post Anesthesia Care Unit

BRANDING KULINER DI KOTA WISATA BERASTAGI KABUPATEN KARO ( STUDI KASUS DI WARUNG WAJIK PECEREN DAN WARUNG SARI TEBU BERASTAGI )

2020 ◽  
Vol 1 (2) ◽  
pp. 69-73
Author(s):  
Zaitun Zaitun
Keyword(s):  
Sugar Cane ◽  
Actual Condition ◽  
Descriptive Research ◽  
Cane Juice ◽  
Sugar Cane Juice ◽  
The Family ◽  
Data Collection Technique ◽  
The City ◽  
Research Type ◽  
Made In

This research was conducted to find out how big the interest of tourists who come to visit wajik stalls and sugar cane juice sweet so that in know whether the two places are worthy made in culinary branding in the city of Berastagi tourism. The method used in this research is qualitative method with descriptive research type which explain the actual condition that happened in the field with data collection technique through observation, interview and documentation. Based on the results of the research can be in the know that in general the interest of visitors to enjoy the menu at the stall wajik peceren better in comparison the interest of visitors in sweet sugar cane stalls. The price offered in these two stalls is very relative and classified as not so expensive and visitors who come to stalls wajik peceren usually buy diamonds that are characteristic of the shop to be brought as by the family at home while the visitors who enjoy the menu at the sweet sugar cane where in general, visitors who come only enjoy the menu on offer, especially Berastagi sugar cane and not brought home as souvenir for the family.

‘To wise for a woman’

2018 ◽  
Author(s):  
Nicola Clark
Keyword(s):  
Marital Problems ◽  
The Core ◽  
The Family ◽  
Made In ◽  
The Way

While there were clear strategic aims in the way that marriages were made in the Howard dynasty during this period, the family was only unusual in that it operated at the very top of the aristocratic hierarchy and was therefore able to use marital alliances to successfully recover and bolster both status and finances. Where they were different, however, was in the experience of some of these women within marriage. By and large, the marriages made by and for members of the family, including women, seem to have been as successful as others of their class. However, three women close to the core of the dynasty experienced severe marital problems, even ‘failed’ marriages, almost simultaneously during the 1520s and 1530s. The records generated by these episodes tell us about the way in which the family operated as a whole, and the agency of women in this context, and this chapter therefore reconstructs these disputes for this purpose.

scholarly journals Effects of pre-emptive pregabalin and multimodal anesthesia on postoperative opioid requirements in patients undergoing robot-assisted laparoscopic prostatectomy

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
K. Sisa ◽  
S. Huoponen ◽  
O. Ettala ◽  
H. Antila ◽  
T. I. Saari ◽  
...  
Keyword(s):  
Postoperative Nausea And Vomiting ◽  
Multimodal Analgesia ◽  
Opioid Consumption ◽  
Anesthesia Induction ◽  
Anesthesia Care ◽  
Post Anesthesia Care Unit ◽  
Robot Assisted ◽  
Ctrl Group ◽  
Laparoscopic Prostatectomy ◽  
The Impact

Abstract Background Previous findings indicate that pre-emptive pregabalin as part of multimodal anesthesia reduces opioid requirements compared to conventional anesthesia in patients undergoing robot-assisted laparoscopic prostatectomy (RALP). However, recent studies show contradictory evidence suggesting that pregabalin does not reduce postoperative pain or opioid consumption after surgeries. We conducted a register-based analysis on RALP patients treated over a 5-year period to evaluate postoperative opioid consumption between two multimodal anesthesia protocols. Methods We retrospectively evaluated patients undergoing RALP between years 2015 and 2019. Patients with American Society of Anesthesiologists status 1–3, age between 30 and 80 years and treated with standard multimodal anesthesia were included in the study. Pregabalin (PG) group received 150 mg of oral pregabalin as premedication before anesthesia induction, while the control (CTRL) group was treated conventionally. Postoperative opioid requirements were calculated as intravenous morphine equivalent doses for both groups. The impact of pregabalin on postoperative nausea and vomiting (PONV), and length of stay (LOS) was evaluated. Results We included 245 patients in the PG group and 103 in the CTRL group. Median (IQR) opioid consumption over 24 postoperative hours was 15 (8–24) and 17 (8–25) mg in PG and CTRL groups (p = 0.44). We found no difference in postoperative opioid requirement between the two groups in post anesthesia care unit, or within 12 h postoperatively (p = 0.16; p = 0.09). The length of post anesthesia care unit stay was same in each group and there was no difference in PONV Similarly, median postoperative LOS was 31 h in both groups. Conclusion Patients undergoing RALP and receiving multimodal analgesia do not need significant amount of opioids postoperatively and can be discharged soon after the procedure. Pre-emptive administration of oral pregabalin does not reduce postoperative opioid consumption, PONV or LOS in these patients.

Analysis Of Post Operative Nausea And Vomiting In The Post Anesthesia Care Unit

2016 ◽  
Vol 31 (4) ◽  
pp. e59-e60
Author(s):  
Alison Partridge ◽  
Suzanne Hunnicutt ◽  
Carol Walker ◽  
Christina Crook ◽  
Shelley Stinson ◽  
...  
Keyword(s):  
Nausea And Vomiting ◽  
Anesthesia Care ◽  
Post Anesthesia Care Unit ◽  
Post Operative Nausea

Infra-popliteal deep venous thrombi and the risk of symptomatic pulmonary embolism in hospitalized patients

Vascular ◽  
2011 ◽  
Vol 19 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Saadi Alhalbouni ◽  
Anil Hingorani ◽  
Alexander Shiferson ◽  
Natalie Marks ◽  
Enrico Ascher
Keyword(s):  
Pulmonary Embolism ◽  
Lower Extremity ◽  
Retrospective Review ◽  
Lower Limb ◽  
Hospitalized Patients ◽  
Symptomatic Pulmonary Embolism ◽  
Number Of Patients ◽  
Significant Difference ◽  
Hospital Patients ◽  
Made In

Infra-popliteal veins include the tibial and peroneal veins, as well as the soleal and gastrocnemial veins collectively known as the calf muscle veins (CMVs). Acute infra-popliteal deep venous thrombi (DVTs) are often considered insignificant with regard to the risk of pulmonary embolism (PE). A retrospective review of 4035 consecutive lower extremity venous duplex scans were made in 3146 hospital patients at our Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL)-accredited vascular lab. Seven hundred sixteen (17.7%) duplex scans were positive for acute DVTs, and 112 (2.8%) were associated with PEs. The breakdown of positive duplexes for acute DVTs was as follows: 202 (28.2%) isolated femoral-popliteal DVTs with PE in 23 (11.4%), 304 (42.5%) isolated infra-popliteal DVTs with PE in 24 (7.9%) and 210 (29.3%) multilevel DVTs involving both vein segments (femoral-popliteal and infra-popliteal) with PE in 38 (18.1%). Of the 304 isolated acute infra-popliteal DVTs, 207 (68.1%) were isolated CMV DVTs with evidence of PE in 12 (5.8%). No statistically significant difference ( P = 0.27) in the risk of PE between isolated femoral-popliteal and isolated infra-popliteal DVTs was noted. A significant number of patients (5.8%) with isolated CMV DVTs developed PE. Lower limb venous scans for DVTs should evaluate the infra-popliteal veins. Hospitalized patients with infra-popliteal DVTs should receive anticoagulation.

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