The Effect of intravenous Ketamine Versus Thiopental in the Preoperative Holding Area on the Separation Anxiety and Emergence Agitation in Children
Hye Young Kim,
Won Sang Lee,
Won Jun Seo,
Kyu Chang Lee
Issue:
Volume 2, Issue 2, March 2014
Pages:
13-17
Received:
24 March 2014
Accepted:
14 April 2014
Published:
30 April 2014
DOI:
10.11648/j.ja.20140202.11
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Abstract: Background: Pre-anesthetic medication is often required in children to provide anxiolysis and to lessen the psychological impact of hospitalization and procedures. In this study, we compared the effects of intravenous ketamine versus thiopental on the separation anxiety and emergence agitation in children undergoing tonsillectomy/adenoidectomy. Methods: Eighty-two children aged 2-8 years scheduled for adenotonsillectomy were enrolled in this prospective double-blind, randomized study. The children were divided into two groups to receive either intravenous ketamine 1 mg/kg (Group K) or thiopental sodium 3 mg/kg (Group T) to facilitate separation from their parents in the preoperative holding area. Anesthesia was induced using 5 mg/kg thiopental sodium in group K and 2 mg/kg in group T, and was maintained using sevoflurane. The separation anxiety score, emergence agitation score, time from stopping the anesthetics to eye opening, extubation time, and postoperative nausea and vomiting were assessed. Results: There were no significant differences between groups K and T in the preoperative separation anxiety score, emergence agitation score and postoperative nausea and vomiting. However, time to eye opening from stopping the anesthetics and extubation time were significantly delayed in group K compared with group T. Conclusions: Intravenous ketamine or thiopental in the preoperative holding area are equally effective decreasing anxiety upon separation from parents and may not affect incidence of emergence agitation. The administration of thiopental used to induce anesthesia appears to be a better choice for preanesthetic medication with careful monitoring.
Abstract: Background: Pre-anesthetic medication is often required in children to provide anxiolysis and to lessen the psychological impact of hospitalization and procedures. In this study, we compared the effects of intravenous ketamine versus thiopental on the separation anxiety and emergence agitation in children undergoing tonsillectomy/adenoidectomy. Met...
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Admissions and Outcomes of Intensive Care Management of Severe Head Injured Patients in Non-Neurosurgical Centres
Abubakar Sadiq Adamu,
Abubakar Alhaji Bakari,
Usman Mohammed Tela,
Babayo Deba Usman,
Yusuf Bukar Ngamdu,
Sambo Tanimu Yusuf
Issue:
Volume 2, Issue 2, March 2014
Pages:
18-21
Received:
27 April 2014
Accepted:
15 May 2014
Published:
30 May 2014
DOI:
10.11648/j.ja.20140202.12
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Abstract: Background: The admissions and outcomes of intensive care management of severe head injured patients depend not only on the standard and effectiveness of the treatment obtained but also on the available technical and human resources. We aimed at auditing the admissions and indeed the outcomes of severe head injured patients admitted in our non-neurosurogical centres. Patients and Methods: This was a retrospective review of the demographic, clinical with neurological data and outcomes of the management of all severely head injured patients admitted to the Intensive Care Units (ICU) of the Federal Teaching Hospital, Gombe and University of Maiduguri Teaching Hospital, Nigeria, for three year duration from January, 2007- December, 2009. Results: The total of 258 cases were retrieved and analyzed within the period under review. Two hundred and thirty one (n=231, 89.53%) were males and twenty seven (n=27, 10.47%) were females. The ages ranges between 1-70 years old with the mean ages of 31.29 (SD=15.66). The length of stay (LOS) from admission to discharge ranged from 1-29 days with the mean of 5.80 days (SD= 6.06) while, the LOS from admission to death ranged from 1-24 days with the mean of 3.62days (SD=4.14). Majority (91.8%) of the causes of the head injury were due to RTA with the mortality rates of 27.9%. Conclusions: A well equipped ICU would greatly facilitate the care of the severely head injured patients and can be an achievable goal in developing countries, if there is rational allocation of resources despite the prevailing challenges. We therefore, recommend the establishment of ICU in general and to encourage physicians to develop interest in the management of severely head injured patients even in a non-neurosurgical ICU.
Abstract: Background: The admissions and outcomes of intensive care management of severe head injured patients depend not only on the standard and effectiveness of the treatment obtained but also on the available technical and human resources. We aimed at auditing the admissions and indeed the outcomes of severe head injured patients admitted in our non-neur...
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