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Tarek Momenah - One of the best experts on this subject based on the ideXlab platform.
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Propofol versus Ketofol for Sedation of Pediatric Patients Undergoing Transcatheter Pulmonary Valve Implantation: A Double-blind Randomized Study.
Annals of Cardiac Anaesthesia, 2017Co-Authors: Rabie Soliman, Mohammed Mofeed, Tarek MomenahAbstract:Objective: The study was done to compare propofol and ketofol for sedation of pediatric patients scheduled for elective pulmonary valve implantation in a catheterization laboratory. Design: This was a double-blind randomized study. Setting: This study was conducted in Prince Sultan Cardiac Centre, Saudi Arabia. Patients and Methods: The study included 60 pediatric patients with pulmonary regurge undergoing pulmonary valve implantation. Intervention: The study included sixty patients, classified into two groups (n = 30). Group A: Propofol was administered as a bolus dose (1–2 mg/kg) and then a continuous infusion of 50–100 μg/kg/min titrated as needed. Group B: Ketofol was administered 1–2 mg/kg and then infusion of 20–60 μg/kg/min. The medication was prepared by the nursing staff and given to anesthetist blindly. Measurements: The monitors included heart rate, mean arterial blood pressure, respiratory rate, temperature, SPO2and PaCO2, Michigan Sedation Score, fentanyl dose, antiemetic medications, and Aldrete Score. Main Results: The comparison of heart rate, mean arterial pressure, respiratory rate, temperature, SPO2and PaCO2, Michigan Sedation Score, and Aldrete Score were insignificant (P > 0.05). The total fentanyl increased in Group A more than Group B (P = 0.045). The required antiemetic drugs increased in Group A patients more than Group B (P = 0.020). The durations of full recovery and in the postanesthesia care unit were longer in Group A than Group B (P = 0.013, P
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Propofol versus Ketofol for Sedation of Pediatric Patients Undergoing Transcatheter Pulmonary Valve Implantation: A Double-blind Randomized Study
Wolters Kluwer Medknow Publications, 2017Co-Authors: Rabie Soliman, Mohammed Mofeed, Tarek MomenahAbstract:Objective: The study was done to compare propofol and ketofol for sedation of pediatric patients scheduled for elective pulmonary valve implantation in a catheterization laboratory. Design: This was a double-blind randomized study. Setting: This study was conducted in Prince Sultan Cardiac Centre, Saudi Arabia. Patients and Methods: The study included 60 pediatric patients with pulmonary regurge undergoing pulmonary valve implantation. Intervention: The study included sixty patients, classified into two groups (n = 30). Group A: Propofol was administered as a bolus dose (1–2 mg/kg) and then a continuous infusion of 50–100 μg/kg/min titrated as needed. Group B: Ketofol was administered 1–2 mg/kg and then infusion of 20–60 μg/kg/min. The medication was prepared by the nursing staff and given to anesthetist blindly. Measurements: The monitors included heart rate, mean arterial blood pressure, respiratory rate, temperature, SPO2and PaCO2, Michigan Sedation Score, fentanyl dose, antiemetic medications, and Aldrete Score. Main Results: The comparison of heart rate, mean arterial pressure, respiratory rate, temperature, SPO2and PaCO2, Michigan Sedation Score, and Aldrete Score were insignificant (P > 0.05). The total fentanyl increased in Group A more than Group B (P = 0.045). The required antiemetic drugs increased in Group A patients more than Group B (P = 0.020). The durations of full recovery and in the postanesthesia care unit were longer in Group A than Group B (P = 0.013, P < 0.001, respectively). Conclusion: The use of propofol and ketofol is safe and effective for sedation of pediatric patients undergoing pulmonary valve implantation in a catheterization laboratory. However, ketofol has many advantages more than the propofol. Ketofol has a rapid onset of sedation, a rapid recovery time, decreased incidence of nausea and vomiting and leads to rapid discharge of patients from the postanesthesia care unit
Vincent Minville - One of the best experts on this subject based on the ideXlab platform.
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Comparison of intubating conditions after induction with propofol and remifentanil or sufentanil
Der Anaesthesist, 2020Co-Authors: A. Dolsan, L. Bruneteau, C. Roche, Fabrice Ferré, François Labaste, A. Sommet, Jean-marie Conil, Vincent MinvilleAbstract:Purpose The aim of this study was to compare tracheal intubation conditions after induction of anesthesia with a bolus of propofol-sufentanil or propofol-remifentanil and a rapid induction technique. Material and methods A total of 70 patients (American Society of Anesthesiologists (ASA) classification I‑II) undergoing outpatient surgery under general anesthesia with intubation for tooth extraction were randomly assigned to two groups in this double-blind study. Patients received either a bolus of remifentanil (3 μg/kg) or sufentanil (0.3 μg/kg) together with 2.5 mg/kg propofol for intubation. The primary outcome was the percentage of excellent intubation conditions and the secondary outcomes were the percentage of patients with a decrease of over 20% in mean arterial pressure (MAP) or heart rate (HR), time to achieve spontaneous respiration, time between the end of surgery and extubation and time to achieve an Aldrete Score of 10. VAS pain Score was >3 or having laryngeal pain 15 min after arriving in the postanesthesia care unit (PACU) were also analyzed. Results Intubating conditions (perfect + good conditions) were significantly better with remifentanil than with sufentanil (88.5% vs. 68.6%; p = 0.01). When using remifentanil, the hemodynamic conditions were good. Using remifentanil did not significantly increase the pain Score or the laryngeal pain in the recovery room. This was confirmed by no significant differences between the groups for morphine consumption. Remifentanil significantly decreased the time to achieve an Aldrete Score of 10. Conclusion When intubation without muscle relaxants is required, intubating conditions are much better when a remifentanil bolus is used compared to a sufentanil bolus. The remifentanil/propofol rapid induction technique is a valuable technique to quickly intubate and achieve good conditions. Zweck Ziel dieser Studie war es, die Bedingungen der Trachealintubation nach Narkoseeinleitung mit einem Bolus Propofol-Sufentanil oder Propofol-Remifentanil und einer schnellen Induktionstechnik zu vergleichen. Material und Methoden In dieser Doppelblindstudie wurden insgesamt 70 Patienten (American Society of Anesthesiologists(ASA)-Klassifikation I–II), bei denen ambulant unter Vollnarkose mit Intubation eine Operation zur Zahnextraktion durchgeführt wurde, in 2 Gruppen randomisiert. Die Patienten erhielten entweder einen Bolus Remifentanil (3 μg/kg) oder Sufentanil (0,3 μg/kg), zusammen mit 2,5 mg/kg Propofol zur Intubation. Das primäre Ergebnis war der Prozentsatz ausgezeichneter Intubationsbedingungen, und die sekundären Ergebnisse waren der prozentuale Anteil der Patienten mit einer Senkung des mittleren arteriellen Drucks (MAP) oder der Herzfrequenz (HR) um mehr als 20 %, die Zeit bis zum Erreichen der Spontanatmung, die Zeit zwischen dem Ende der Operation und der Extubation sowie die Zeit bis zum Erreichen eines Aldrete-Scores von 10. Der prozentuale Anteil der Patienten mit einem SchmerzScore >3 oder mit Kehlkopfschmerzen 15 min nach Ankunft auf der „postanesthesia care unit“ (PACU) wurde ebenfalls analysiert. Ergebnisse Die Intubationsbedingungen waren mit Remifentanil signifikant besser als mit Sufentanil (51,4 % vs. 20 %; p = 0,0064). Bei der Verwendung von Remifentanil waren die hämodynamischen Bedingungen gut. Die Verwendung von Remifentanil führte zu keiner signifikanten Erhöhung des SchmerzScores oder der Kehlkopfschmerzen im Aufwachraum. Dies wurde dadurch bestätigt, dass es keine signifikanten Unterschiede in den Gruppen für die Morphineinnahme gab. Remifentanil verkürzte die Zeit bis zum Erreichen eines Aldrete-Scores von 10 signifikant. Schlussfolgerung Wenn eine Intubation ohne Muskelrelaxanzien erforderlich ist, sind die Intubationsbedingungen bei Verwendung eines Remifentanil-Bolus wesentlich besser als bei Verwendung eines Sufentanil-Bolus. Die Methode der schnellen Induktion durch Remifentanil/Propofol ist eine wertvolle Technik, mit der eine schnelle Intubation möglich ist und gute Bedingungen erreicht werden können.
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Comparison of intubating conditions after induction with propofol and remifentanil or sufentanil : Randomized controlled REMIDENT trial for surgical tooth extraction.
Anaesthesist, 2020Co-Authors: A. Dolsan, L. Bruneteau, C. Roche, Fabrice Ferré, François Labaste, A. Sommet, Jean-marie Conil, Vincent MinvilleAbstract:The aim of this study was to compare tracheal intubation conditions after induction of anesthesia with a bolus of propofol-sufentanil or propofol-remifentanil and a rapid induction technique. A total of 70 patients (American Society of Anesthesiologists (ASA) classification I‑II) undergoing outpatient surgery under general anesthesia with intubation for tooth extraction were randomly assigned to two groups in this double-blind study. Patients received either a bolus of remifentanil (3 μg/kg) or sufentanil (0.3 μg/kg) together with 2.5 mg/kg propofol for intubation. The primary outcome was the percentage of excellent intubation conditions and the secondary outcomes were the percentage of patients with a decrease of over 20% in mean arterial pressure (MAP) or heart rate (HR), time to achieve spontaneous respiration, time between the end of surgery and extubation and time to achieve an Aldrete Score of 10. VAS pain Score was >3 or having laryngeal pain 15 min after arriving in the postanesthesia care unit (PACU) were also analyzed. Intubating conditions (perfect + good conditions) were significantly better with remifentanil than with sufentanil (88.5% vs. 68.6%; p = 0.01). When using remifentanil, the hemodynamic conditions were good. Using remifentanil did not significantly increase the pain Score or the laryngeal pain in the recovery room. This was confirmed by no significant differences between the groups for morphine consumption. Remifentanil significantly decreased the time to achieve an Aldrete Score of 10. When intubation without muscle relaxants is required, intubating conditions are much better when a remifentanil bolus is used compared to a sufentanil bolus. The remifentanil/propofol rapid induction technique is a valuable technique to quickly intubate and achieve good conditions.
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Comparison of intubating conditions after induction with propofol combined with remifentanil or sufentanil in surgical tooth extraction: a randomized controlled trial
2019Co-Authors: A. Dolsan, L. Bruneteau, C. Roche, Fabrice Ferré, François Labaste, A. Sommet, Jean-marie Conil, Vincent MinvilleAbstract:Abstract Background The aim of this study was to compare tracheal intubation conditions after anesthetic induction bolus of propofol-sufentanil or propofol-remifentanil. Methods A total of 70 patients, ASA I-II undergoing ambulatory surgery under general anesthesia with intubation for tooth extraction were randomly assigned in this double-blind study. They received either remifentanil (3 μg/kg) or sufentanil (0,3 μg/kg) associated with 2,5 mg/kg of propofol for intubation. Intubating conditions Score were compared using the Scandinavian scale. The primary outcome was the comparison of the percentage of excellent intubation conditions. The secondary outcomes were the percentage of patients with a decrease of over 20% in MAP or HR, time to have a spontaneous respiration, time between the end of the surgery and extubation, time to obtain an Aldrete Score of 10. The percentage of patients having a pain Score>3 or having laryngeal pain 15 minutes after arriving in PACU were also analyzed. Discussion Compared with the sufentanil group, intubating conditions were significantly better in the remifentanil group (51.4% vs. 20%; p=0.0064). When using remifentanil, the hemodynamic conditions were good. Using remifentanil did not increase significantly the pain Score or the laryngeal pain in recovery room. This is confirmed by the fact that morphine consumption was not significantly different in the two groups. Injecting remifentanil decreased significantly the time to obtain an Aldrete Score of 10. When intubating without muscle relaxants is required, intubating conditions are widely better when remifentanil is used in comparison with sufentanil. Study registration This study was approved by the research ethics board (protocol number 09.001.03, favorable opinion of the CPP Sud-Ouest et Outre-Mer 1 dated January 19, 2011) and written informed consent was obtained from each patient. This trial was registered at ClinicalTrials.gov (NCT01533662).
Rabie Soliman - One of the best experts on this subject based on the ideXlab platform.
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Propofol versus Ketofol for Sedation of Pediatric Patients Undergoing Transcatheter Pulmonary Valve Implantation: A Double-blind Randomized Study.
Annals of Cardiac Anaesthesia, 2017Co-Authors: Rabie Soliman, Mohammed Mofeed, Tarek MomenahAbstract:Objective: The study was done to compare propofol and ketofol for sedation of pediatric patients scheduled for elective pulmonary valve implantation in a catheterization laboratory. Design: This was a double-blind randomized study. Setting: This study was conducted in Prince Sultan Cardiac Centre, Saudi Arabia. Patients and Methods: The study included 60 pediatric patients with pulmonary regurge undergoing pulmonary valve implantation. Intervention: The study included sixty patients, classified into two groups (n = 30). Group A: Propofol was administered as a bolus dose (1–2 mg/kg) and then a continuous infusion of 50–100 μg/kg/min titrated as needed. Group B: Ketofol was administered 1–2 mg/kg and then infusion of 20–60 μg/kg/min. The medication was prepared by the nursing staff and given to anesthetist blindly. Measurements: The monitors included heart rate, mean arterial blood pressure, respiratory rate, temperature, SPO2and PaCO2, Michigan Sedation Score, fentanyl dose, antiemetic medications, and Aldrete Score. Main Results: The comparison of heart rate, mean arterial pressure, respiratory rate, temperature, SPO2and PaCO2, Michigan Sedation Score, and Aldrete Score were insignificant (P > 0.05). The total fentanyl increased in Group A more than Group B (P = 0.045). The required antiemetic drugs increased in Group A patients more than Group B (P = 0.020). The durations of full recovery and in the postanesthesia care unit were longer in Group A than Group B (P = 0.013, P
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Propofol versus Ketofol for Sedation of Pediatric Patients Undergoing Transcatheter Pulmonary Valve Implantation: A Double-blind Randomized Study
Wolters Kluwer Medknow Publications, 2017Co-Authors: Rabie Soliman, Mohammed Mofeed, Tarek MomenahAbstract:Objective: The study was done to compare propofol and ketofol for sedation of pediatric patients scheduled for elective pulmonary valve implantation in a catheterization laboratory. Design: This was a double-blind randomized study. Setting: This study was conducted in Prince Sultan Cardiac Centre, Saudi Arabia. Patients and Methods: The study included 60 pediatric patients with pulmonary regurge undergoing pulmonary valve implantation. Intervention: The study included sixty patients, classified into two groups (n = 30). Group A: Propofol was administered as a bolus dose (1–2 mg/kg) and then a continuous infusion of 50–100 μg/kg/min titrated as needed. Group B: Ketofol was administered 1–2 mg/kg and then infusion of 20–60 μg/kg/min. The medication was prepared by the nursing staff and given to anesthetist blindly. Measurements: The monitors included heart rate, mean arterial blood pressure, respiratory rate, temperature, SPO2and PaCO2, Michigan Sedation Score, fentanyl dose, antiemetic medications, and Aldrete Score. Main Results: The comparison of heart rate, mean arterial pressure, respiratory rate, temperature, SPO2and PaCO2, Michigan Sedation Score, and Aldrete Score were insignificant (P > 0.05). The total fentanyl increased in Group A more than Group B (P = 0.045). The required antiemetic drugs increased in Group A patients more than Group B (P = 0.020). The durations of full recovery and in the postanesthesia care unit were longer in Group A than Group B (P = 0.013, P < 0.001, respectively). Conclusion: The use of propofol and ketofol is safe and effective for sedation of pediatric patients undergoing pulmonary valve implantation in a catheterization laboratory. However, ketofol has many advantages more than the propofol. Ketofol has a rapid onset of sedation, a rapid recovery time, decreased incidence of nausea and vomiting and leads to rapid discharge of patients from the postanesthesia care unit
Dalia Ahmed Ibrahim - One of the best experts on this subject based on the ideXlab platform.
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Dexmedetomidine versus propofol for sedation in stereotactic brain biopsy: a comparative study
Ain-Shams Journal of Anesthesiology, 2019Co-Authors: Ghada Mohamed Samir, Dalia Ahmed IbrahimAbstract:Background The aim of this study was to assess the effectiveness of intraoperative dexmedetomidine versus propofol infusions on the sedation and the recovery profiles during stereotactic brain biopsy. A total of 40 patients of American Society of Anesthesiologists (ASA) physical status II were randomly divided to receive either dexmedetomidine hydrochloride (group D) or propofol (group P). The time to reach Ramsay sedation scale of 2–4, as well as the recovery profile by the modified Aldrete Score, was recorded. Results The heart rate (HR) in group D was significantly lower than that in group P, starting from 2 min after the loading doses and during the whole painful steps of the procedure. The systolic blood pressure (SBP) showed a statistically non-significant decrease over time in both groups except at 2 min after the loading dose in group D, when it was significantly lower than the baseline value. The diastolic blood pressure (DBP) showed a statistically significant decrease over time in group D, starting from 2 min after the loading dose and with skin incision, during burr-hole drilling of the skull and with the dural stitch. The decrease in respiratory rate (RR) recorded 2 min after the loading dose in group P was statistically non-significant to the baseline value; it resulted in a statistically significant decrease in the arterial oxygen saturation (SpO_2) and statistically significant higher end tidal carbon dioxide (etCO_2) values that continued till the skin incision. As regards the time to reach Ramsay sedation scale (RSS) of 2–4 and a modified Aldrete Score of ≥ 9, they were statistically but not clinically significantly less in group P. However, the time till the first request of analgesia was statistically and clinically significantly more in group D. Conclusion Dexmedetomidine offers rapid onset and recovery of sedation, as well as hemodynamic stability with post-operative analgesic effect during day-case stereotactic brain biopsy surgery.
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Dexmedetomidine versus propofol for sedation in stereotactic brain biopsy: a comparative study
Ain-Shams Journal of Anesthesiology, 2019Co-Authors: Ghada Mohamed Samir, Dalia Ahmed IbrahimAbstract:The aim of this study was to assess the effectiveness of intraoperative dexmedetomidine versus propofol infusions on the sedation and the recovery profiles during stereotactic brain biopsy. A total of 40 patients of American Society of Anesthesiologists (ASA) physical status II were randomly divided to receive either dexmedetomidine hydrochloride (group D) or propofol (group P). The time to reach Ramsay sedation scale of 2–4, as well as the recovery profile by the modified Aldrete Score, was recorded. The heart rate (HR) in group D was significantly lower than that in group P, starting from 2 min after the loading doses and during the whole painful steps of the procedure. The systolic blood pressure (SBP) showed a statistically non-significant decrease over time in both groups except at 2 min after the loading dose in group D, when it was significantly lower than the baseline value. The diastolic blood pressure (DBP) showed a statistically significant decrease over time in group D, starting from 2 min after the loading dose and with skin incision, during burr-hole drilling of the skull and with the dural stitch. The decrease in respiratory rate (RR) recorded 2 min after the loading dose in group P was statistically non-significant to the baseline value; it resulted in a statistically significant decrease in the arterial oxygen saturation (SpO2) and statistically significant higher end tidal carbon dioxide (etCO2) values that continued till the skin incision. As regards the time to reach Ramsay sedation scale (RSS) of 2–4 and a modified Aldrete Score of ≥ 9, they were statistically but not clinically significantly less in group P. However, the time till the first request of analgesia was statistically and clinically significantly more in group D. Dexmedetomidine offers rapid onset and recovery of sedation, as well as hemodynamic stability with post-operative analgesic effect during day-case stereotactic brain biopsy surgery.
Mohammed Mofeed - One of the best experts on this subject based on the ideXlab platform.
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Propofol versus Ketofol for Sedation of Pediatric Patients Undergoing Transcatheter Pulmonary Valve Implantation: A Double-blind Randomized Study.
Annals of Cardiac Anaesthesia, 2017Co-Authors: Rabie Soliman, Mohammed Mofeed, Tarek MomenahAbstract:Objective: The study was done to compare propofol and ketofol for sedation of pediatric patients scheduled for elective pulmonary valve implantation in a catheterization laboratory. Design: This was a double-blind randomized study. Setting: This study was conducted in Prince Sultan Cardiac Centre, Saudi Arabia. Patients and Methods: The study included 60 pediatric patients with pulmonary regurge undergoing pulmonary valve implantation. Intervention: The study included sixty patients, classified into two groups (n = 30). Group A: Propofol was administered as a bolus dose (1–2 mg/kg) and then a continuous infusion of 50–100 μg/kg/min titrated as needed. Group B: Ketofol was administered 1–2 mg/kg and then infusion of 20–60 μg/kg/min. The medication was prepared by the nursing staff and given to anesthetist blindly. Measurements: The monitors included heart rate, mean arterial blood pressure, respiratory rate, temperature, SPO2and PaCO2, Michigan Sedation Score, fentanyl dose, antiemetic medications, and Aldrete Score. Main Results: The comparison of heart rate, mean arterial pressure, respiratory rate, temperature, SPO2and PaCO2, Michigan Sedation Score, and Aldrete Score were insignificant (P > 0.05). The total fentanyl increased in Group A more than Group B (P = 0.045). The required antiemetic drugs increased in Group A patients more than Group B (P = 0.020). The durations of full recovery and in the postanesthesia care unit were longer in Group A than Group B (P = 0.013, P
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Propofol versus Ketofol for Sedation of Pediatric Patients Undergoing Transcatheter Pulmonary Valve Implantation: A Double-blind Randomized Study
Wolters Kluwer Medknow Publications, 2017Co-Authors: Rabie Soliman, Mohammed Mofeed, Tarek MomenahAbstract:Objective: The study was done to compare propofol and ketofol for sedation of pediatric patients scheduled for elective pulmonary valve implantation in a catheterization laboratory. Design: This was a double-blind randomized study. Setting: This study was conducted in Prince Sultan Cardiac Centre, Saudi Arabia. Patients and Methods: The study included 60 pediatric patients with pulmonary regurge undergoing pulmonary valve implantation. Intervention: The study included sixty patients, classified into two groups (n = 30). Group A: Propofol was administered as a bolus dose (1–2 mg/kg) and then a continuous infusion of 50–100 μg/kg/min titrated as needed. Group B: Ketofol was administered 1–2 mg/kg and then infusion of 20–60 μg/kg/min. The medication was prepared by the nursing staff and given to anesthetist blindly. Measurements: The monitors included heart rate, mean arterial blood pressure, respiratory rate, temperature, SPO2and PaCO2, Michigan Sedation Score, fentanyl dose, antiemetic medications, and Aldrete Score. Main Results: The comparison of heart rate, mean arterial pressure, respiratory rate, temperature, SPO2and PaCO2, Michigan Sedation Score, and Aldrete Score were insignificant (P > 0.05). The total fentanyl increased in Group A more than Group B (P = 0.045). The required antiemetic drugs increased in Group A patients more than Group B (P = 0.020). The durations of full recovery and in the postanesthesia care unit were longer in Group A than Group B (P = 0.013, P < 0.001, respectively). Conclusion: The use of propofol and ketofol is safe and effective for sedation of pediatric patients undergoing pulmonary valve implantation in a catheterization laboratory. However, ketofol has many advantages more than the propofol. Ketofol has a rapid onset of sedation, a rapid recovery time, decreased incidence of nausea and vomiting and leads to rapid discharge of patients from the postanesthesia care unit