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Effect of oral Premedication of midazolam, ketamine, and dexmedetomidine on pediatric sedation and ease of parental separation in anesthesia induction for elective surgery: A randomized clinical trial

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Journal of Acute Disease 2022年第4期11卷 133-139页

作者： Aref Zarei Hesameddin Modir Behnam Mahmoodiyeh Alireza Kamali Farzad Zamani-Barsari Student Research Committee Arak University of Medical SciencesArakIran Anesthesiology Department Arak University of Medical SciencesArakIran Department of ENT Surgery Arak University of Medical SciencesArakIran

Objective:To compare effect of midazolam,dexmedetomidine,and ketamine as oral Premedication on pediatric sedation and ease of parental separation anxiety in anesthesia induction.Methods:This multicenter,prospective,randomized,double-blind,clinical trial focused on a pediatric population aged 2-7 years(n=153)with the American Society of AnesthesiologistsⅠ-Ⅱwho required elective surgery.The patients were stratified into three intervention groups:midazolam,ketamine,and dexmedetomidine.Hemodynamic parameters(blood pressure,heart rate,and oxygen saturation)every 5 min until induction of anesthesia along with non-hemodynamic factors,comprised of sedation score before the administration and at the time of being separated from the parents,as well as parental separation anxiety scale,acceptance of anesthesia induction,and side effects were recorded and compared.Results:No statistically significant difference in oxygen saturation,heart rate,blood pressure,duration of surgery,time to achieve an Aldrete score of 9-10,or sedation score was noted in the study groups.More patients in the dexmedetomidine and midazolam groups could better ease parental separation anxiety than the ketamine group(P=0.001).Moreover,fewer patients accept anesthesia induction(P=0.001)and more had side effects in the ketamine group(P=0.047).Conclusions:Our findings indicate that compared to the ketamine group,dexmedetomidine and midazolam are better in easing parental separation anxiety and accepting induction of anesthesia with fewer side effects.Dexmedetomidine and midazolam may be considered better choices.However,the final choice hinges on the patient's specific physical condition and the anesthesiologist's preference.Clinical registarion:This study is registered in the Iranian Registry Clinical Trial center with the clinical trial code of IRCT20211007052693N1.

关键词： Dexmedetomidine Ketamine Midazolam Premedication Sedation

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Cerebral protective effect of nicorandil Premedication on patients undergoing liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2012年第2期11卷 132-136页

作者： Yun-Fei Xia,Zheng-Ping Wang,Ya-Chun Zhou,Tao Yan and Shi-Tong Li Department of Anesthesiology, Shanghai First People’s Hospital, Medical College, Shanghai Jiaotong University, Shanghai 200080, China Department of Anesthesiology，Shanghai First People's Hospital，Medical college，Shanghai Jiaotong University，Shanghai 200080，China Xia YF，Wang ZP，Zhou YC，Yan T and Li ST

BACKGROUND:Neurological injury is a common complication in the early period after liver transplantation,posing an enormous obstacle to treatment efficiency and patient survival.Nicorandil is a mitochondrial ATP-sensitive potassium channel(mitoK ATP) opener.It has been reported to be effective in reducing brain injury in recent studies.However,it is still unclear whether nicorandil has cerebral protective effect in patients undergoing liver transplantation.METHODS:Fifty patients scheduled for liver transplantation were randomly divided into a nicorandil group(group N)(n=25),in which patients received 10 mg nicorandil through a nasogastric tube 30 minutes before induction of anesthesia,and a control group(group C)(n=25) who received 10 mL normal saline.The Mini-Mental State Examination(MMSE) was performed before anesthesia(day 0),and on days 3 and 7 after surgery.Blood samples were obtained before induction of anesthesia(T1),and at 12(T2) and 36 hours(T3) after surgery for determination of serum neuron-specific enolase(NSE) and S100β protein(S100β) concentrations.RESULTS:During surgery,5 patients in each group were eliminated due to severe reperfusion or renal insufficiency.Therefore,20 patients remained in each group.The MMSE scores after operation were significantly lower than those before operation in group C.However,there was no difference at days 3 and 7 compared with day 0 in group N.Serum NSE concentrations after surgery were significantly higher than baseline(at T1) in both groups,except at T3 in group N.Serum S100β concentration after surgery was significantly higher than baseline(at T1) in both groups.The MMSE scores at days 3 and 7 in group N were significantly higher than those in group C.The concentrations of serum NSE and S100β at T2 and T3 in group N were significantly lower than those in group C.CONCLUSIONS:Oral nicorandil,as a Premedication before liver transplantation,improves postoperative MMSE scores.It also attenuates the increase of NSE and S100β in blood,indicating its cerebral protective eff

关键词： nicorandil Premedication liver transplantation cerebral protection

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Efficacy of small-volume simethicone given at least 30 min before gastroscopy

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2016年第4期7卷 572-578页

作者： Mingjun Song Andrew Boon Eu Kwek Ngai Moh Law Jeannie Peng Lan Ong Jessica Yi-Lyn Tan Prem Harichander Thurairajah Daphne Shih Wen Ang Tiing Leong Ang Department of Gastroenterology and Hepatology Changi General Hospital

AIM To evaluate the efficacy of 5 m L simethicone solution in decreasing gastric foam if given at least 30 min before gastroscopy.METHODS This was a randomized, placebo controlled, endoscopist blinded study performed at Changi General Hospital. Patients were at least 21 years old, had no prior sur-gical resection of the upper gastrointestinal tract, and scheduled for elective diagnostic gastroscopies. The primary outcome was the total mucosal visibility score(TMVS) which was evaluated using Mc Nally score. The sample size was calculated to be 24 per group(SD 2.4, 80% power, P Premedication time of at least 30 min, 5 m L simethicone can significantly decrease gastric foam, decrease the volume of additional flushes, and shorten gastroscopy time.

关键词： Simethicone Premedication Gastroscopy 胃的泡沫

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The optimum dose of intranasal remifentanil for laryngeal mask airway insertion during sevoflurane induction in children:a randomized controlled trial

The optimum dose of intranasal remifentanil for laryngeal ma...

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2016中国中西医结合麻醉学会[CSIA]年会暨第三届全国中西医结合麻醉学术研讨会、河南省中西医结合学会麻醉专业委员会成立大会

作者： Yusheng Yao Yang Yang Yanqing Chen Department of Anesthesiology The Shengli ClinicalMedicalCollegeFujian Medical University

Objective:The purpose of this study was to determine the optimum dose of intranasal remifentanil required to produce satisfactory laryngeal mask airway(LMA) insertion conditions during inhalation indu

关键词： volatile anesthetics sevoflurane potency Premedication intranasal opioid remifentanil laryngeal mask airway

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Efforts to increase image quality during endoscopy:The role of pronase

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World Journal of Gastrointestinal Endoscopy 2016年第5期8卷 267-272页

作者： Gwang Ha Kim Yu Kyung Cho Jae Myung Cha Sun-Young Lee Il-Kwun Chung Department of Internal Medicine Pusan National University School of Medicine and Biomedical Research InstitutePusan National University Hospital Department of Internal Medicine the Catholic University of KoreaCollege of Medicine Department of Internal Medicine Kyung Hee University Hospital at Gang DongKyung Hee University School of Medicine Department of Internal Medicine Konkuk University School of Medicine Department of Internal Medicine Soonchunhyang University Cheonan HospitalSoonchunhyang University College of Medicine

Clear visualization of the gastrointestinal mucosal surface is essential for thorough endoscopy. An unobstructed assessment can reduce the need for additional timeconsuming manipulations such as frequent washing and suction,which tend to prolong total procedure time. However,mucus,foam,and bubbles often hinder clear visibility during endoscopy. Premedication with pronase,a compound of mixed proteolytic enzymes,has been studied in order to improve mucosal visibility during endoscopy. Although its effects differ according to the location in the stomach,Premedication with pronase 10 to 20 min before endoscopy significantly improves mucosal visibility without affecting the accuracy of Helicobacter pylori identification. The effects of pronase as Premedication also extend to chromoendoscopy,narrow-band imaging,magnifying endoscopy,and endoscopic ultrasonography. In addition,endoscopic flushing with pronase during endoscopy may improve the quantity and the quality of a biopsy to some degree. Although improved mucosal visibility does not necessarily improve clinical outcomes,Premedication with pronase may be helpful for increasing the detection rate of early cancers.

关键词： Endoscopy Premedication Pronase

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Preoperative Sedation, Hemodynamic Stability during General Anesthesia and Improving Postoperative Pain: Pregabalin Is the Answer

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Open Journal of Anesthesiology 2018年第1期8卷 14-26页

作者： Heba El-Hussiny Huda Fahmy Ayman Mohammad Eldemrdash Department of Anesthesia Aswan University Hospital Aswan Egypt

Background: Tracheal intubation is a noxious stimulus that tends to provoke a marked sympathetic response which is potentially deleterious in some patients. Various methods have been used to minimize and attenuate these potentially harmful responses. Aim of the study: The present study compared the efficacy and safety of two different doses (150 mg and 300 mg) of oral pregabalin Premedication on attenuation of the hemodynamic pressor response to airway instrumentation, perioperative hemodynamic stability, preoperative sedation, and postoperative pain reduction. Patients and methods: This prospective, observational study consisted of 60 adult patients scheduled for laparoscopic cholecystectomy. The patients were randomized into three groups of 20 patients each. Group I (P0) received an oral placebo, group II (P150) received 150 mg of oral pregabalin and group III (P300) received 300 mg of oral pregabalin 1 h prior to induction. All patients were assessed for pre-operative sedation, perioperative hemodynamic changes, Post-operative pain and analgesic consumption. Results: Regarding the efficacy of the preoperative administration of oral pregabalin, a dose dependent attenuation in the increased in heart rate, systolic, and diastolic blood pressure, and mean arterial blood pressure resulting from laryngoscopy and intubation was observed (300 mg > 150 mg), along with a subsequent decrease in intraoperative fentanyl supplementation. On anxiolysis, patients were more comfortable and asleep in the pregabalin groups as compared with the control group, in which more patients were awake and agitated. Post-operative pain and analgesic consumption were effectively reduced by (150 mg and 300 mg) pregabalin in a dose-dependent manner. Postoperative nausea and vomiting were significantly lower with the administration of pregabalin compared with the placebo group (P Premedication

关键词： Pregabalin Premedication Sedation Postoperative Pain

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