Nurse Anesthesia

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https://hdl.handle.net/20.500.11888/3201

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Browsing Nurse Anesthesia by Author "Ibrahim Swaiti"

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    COMPARISON OF POST-OPERATIVE AGITATION BETWEEN INHALATIONAL ANESTHESIA AND TOTAL INTRAVENOUS ANESTHESIA IN CHILDREN UNDERGOING TONSILLECTOMY\ ADENOIDECTOMY.
    (2022-09-13) Ibrahim Swaiti
    Background: Tonsillectomy is a surgical procedure performed with or without adenoidectomy that completely removes the tonsil, a common complication in children undergoing general anesthesia is postoperative agitation. Aim: To compare the effect of inhalation anesthesia (sevoflurane) and total intravenous anesthesia (TIVA) by using propofol on postoperative emergence agitation in pediatric patients undergoing tonsillectomy/adenoidectomy. Methods: 80 children between the ages of 3 and 10 who were classified as ASA I and II received elective tonsillectomy/adenoidectomy as part of this prospective randomized, controlled, double-blinded research. The subjects were divided into two anesthetic groups at random: group 1 (P) Propofol (experiment group), which included 40 patients, and group 2 (S) Sevoflurane (control group), which included the same number of patients. A bolus injection of 3 mg/kg of propofol was used to produce anesthesia in group 1 (P), and a propofol infusion at a rate of 100–250 µg/kg/min was used to maintain it. Sevoflurane 7% was used to induce anesthesia in group 2(S), which was then maintained with 1MAC sevoflurane according to this age group and a bolus dose of 3 mg/kg of propofol was given at induction. Results: The mean of SAS in group S (Mean=4.55) is significantly higher than the mean of SAS in group P (Mean=3.83), P= <0.001. According to this, patients in the S group exhibit higher emerging agitation than those in the P group. The mean of VAS_P in group S (Mean=1.75) is significantly higher than the mean of VAS_P in group P (Mean=0.8), p=0.037. And the incidence of pain in the area of surgery cases in group S (N=40, P=100%) is significantly higher than the incidence of pain in group P (N=28, P=70%), P= 0.032, this demonstrates that the S group has a higher incidence and severity of pain than the P group. The mean of VAS_N in group S (Mean=1.69) is significantly higher than the mean of VAS_N in group P (Mean=0.55), P= 0.004. And the incidence of nausea in group S (N=19, P=48%) is significantly higher than the incidence of nausea in group P (N=8, P=20%). Regarding the incidence of vomiting in group S (N=12, P=30%) is significantly higher than the incidence of vomiting in group P (N=1, P=3%), P= 0.001. The incidence of retching in group S (N=8, P=20%) is significantly higher than the incidence of retching in group P (N=2, P=5%), this shows that the S group experiences nausea, vomiting, and retching more frequently and intensely than the P group. The incidence of drowsiness / dizziness in group S is significantly higher than the incidence of the drowsiness/dizziness in group P (N=3, P=8%), P= 0.001. Conclusions: In comparison to inhalational anesthesia with sevoflurane, total intravenous anesthesia with propofol decreased the likelihood of postoperative emergence of agitation, intensity of nausea, vomiting, retching, bleeding, hunger, thirsty and drowsiness/dizziness in children patients following tonsillectomy/adenoidectomy. Keywords: Tonsillectomy, Adenoidectomy, Total intravenous anesthesia (TIVA) Inhalational anesthesia, Sevoflurane, propofol, Emergence of Agitation, Nausea, Vomiting.