Intranasal Sufentanil/Midazolam Versus Ketamine/ Midazolam for Analgesia/Sedation: Result

In: Anesthesia

21 Sep 2009

Patients in the 2 groups were similar with respect to age, height, weight, gender distribution, and length of surgery, and the number of teeth removed (Table 1). There were no significant differences (P = .05) in the physiological parameters, namely blood pressures (systolic, diastolic, mean arterial), heart rates, respiratory rates, and oxygen saturation between the 2 groups at the various time intervals measured (Table 2). With regard to the preoperative sedation and anxiety levels at the intervals post-drug administration, no significant differences were found between the 2 groups (P = 0.05) (Figures 1 and 2). Significantly more patients in the S/ M group accepted the nasal premedication (chi-square test = 7.718, P = .021; Table 3). No significant differences were found in the ease of mask induction (P = .05; Table 4). No adverse effects like nausea, vomiting, itching, and excessive sedation were observed in either group. There were no significant differences seen between the 2 groups as far as postoperative recovery went (P = .05; Table 4). The Oucher facial pain scale showed the S/M group to experience less pain than those in the K/M group, although this was not statistically significant (P > .05) (Table 4). In the S/M group, 72% of children were responders as compared with 52% in the K/M group (P > .05; Figure 3). Using the word graphic rating scale and the modified Hannalah objective pain scale (Table 4 and Figures 4 and 5), no significant differences were found between the 2 groups at the various time intervals measured postoperatively (P – .05).

Table 1. Demographic Profile and Baseline Vital Signs in the 2 Groups*

Group S/M Mean ± SD

Group K/M Mean ± SD

Age (year)

5.87 ±

1.33

5.68 ±

1.31

Weight (kg)

17.80 ±

2.72

17.17 ±

3.09

Number of teeth

10.68 ±

3.77

10.63 ±

4.26

Heart rate

94.48 ±

26.22

105.16 ±

20.64

(beats/min)

Duration of surgery

20.64 ±

6.60

19.96 ±

4.95

Gender

Male

15

12

Female

10

13

* S/M indicates sufentanil/midazolam; K/M, ketamine/mid-azolam.

Table 2. Psyhological parametrs  levitra plus

Table 2. Physiological

Table 3. Acceptance of Intranasal Spray*

Good

Moderate

Poor

Total

Group K/M

4

9

12

25

Group S/M

7 15

3

25

Total

11 24

15

50

Table 4. Mask Acceptance Score, Recovery Room Score, and Pain Measures*

Mean ± SD

S/M group, mask induction

acceptance score K/M group, mask induction

acceptance score

42.40 ± 2.92 39.69 ± 7.49

Time

30 minutes

60 minutes

90 minutes

120 minutes

S/M group, recovery room score

K/M group recovery room score

S/M group, sum of Hannalah

scale (%) K/M group, sum of Hannalah

scale (%)

78.40 ± 15.46 74.80 ± 13.88 29.00 ± 25.36 26.00 ± 22.35 81.60 ± 8.50 80.00 ± 7.64 21.33 ± 24.66 14.33 ± 14.74 11.33 ± 13.58 10.67 ± 13.29 81.67 ± 6.37 79.58 ± 10.42 10.33 ± 12.33 9.33 ± 12.80

Child

Mother

Researcher

S/M group, oucher sum K/M group, oucher sum

86.40 ± 85.82 115.20 ± 89.36

86.00 ± 85.63 115.60 ± 88.98

84.00 ± 83.22 114.00 ± 90.00

* S/M indicates subfentanil/midazolam; K/M, ketamine/midazolam.

Table 5. Modified Hannalah Objective Pain Scale

Observation Criteria

Points

Blood Pressure

± 10% preop

0

>20% preop

1

>30% preop

2

Crying

Not crying

0

Crying but responds to tender

1

loving care

Crying and does not respond

2

to tender loving care

Movement

None

0

Restless

1

Thrashing

2

Agitation

Patient asleep or calm

0

Mild

1

Hysterical

2

Posture

No special posture

0

Flexing limbs

1

Holding mouth

2

Complaints of pain

Asleep or states no pain

0

Cannot localize

1

Can localize

2

Figure 1. Sedation score: 15 and 20 minutes post-drug ad­ministration. viagra plus

Figure 1. Sedation score

Figure 2. Anxiety scale: baseline, 15, and 20 minutes post-drug administration.

Figure 2. Anxiety scale

Figure 3. Oucher score categories for observer/researcher.

Figure 3. Oucher score

Figure 4. Word graphic rating scale for observer/researcher.

Figure 4. Word graphic

Figure 5. Modified Hannalah objective pain scale: for observer/researcher.

Figure 5. Modified Hannalah


About this blog

Blog invites submissions of review articles, reports on clinical techniques, case reports, conference summaries, and articles of opinion pertinent to the control of pain and anxiety in dentistry.

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