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clonidine in tonsillectomy

F Alm, M Jaensson, S Lundeberg, E Ericsson
BACKGROUND: Pain management in children after tonsil surgery is essential, and optimal pain treatment has been discussed for many years. Data from the National Tonsil Register in Sweden (NTRS) and a national mapping have demonstrated the need for national pain treatment guidelines for pediatric tonsil surgery. As a result, Swedish national guidelines, together with updated patient information on the website, were developed and implemented in 2013. OBJECTIVES: The objective of this study was to evaluate the professionals' opinions of and adherence to pain treatment guidelines for pediatric tonsil surgery patients in a two-year follow-up...
October 2017: International Journal of Pediatric Otorhinolaryngology
R Vlok, T M Melhuish, C Chong, T Ryan, Leigh D White
The infiltration of local anaesthetic agents has been shown to reduce post-tonsillectomy pain. A number of recent studies have shown that the addition of agents such as clonidine and dexamethasone improve the efficacy of nerve blocks and spinal anaesthesia. The aim of this review was to determine whether additives to local anaesthetic agents improve post-tonsillectomy outcomes. Four major databases were systematically searched for all relevant studies published up to August 2016. All study designs with a control group receiving local anaesthetic infiltration and an intervention receiving the same infiltration with an added agent were included in this review...
August 2017: Journal of Anesthesia
E Ericsson, M Brattwall, S Lundeberg
BACKGROUND: Surgery of the tonsils often causes severe pain lasting for many days as been shown by data from the National Tonsil Surgery Register in Sweden. Tonsillotomy is associated with fewer readmissions due to bleeding, number of days requiring analgesics and health care contacts due to pain compared to tonsillectomy. The register data demonstrate the necessity of better-evidenced based pain treatment guidelines for tonsil-surgery. OBJECTIVES: To develop evidenced based pain treatment guidelines for tonsil-surgery in Sweden...
April 2015: International Journal of Pediatric Otorhinolaryngology
Lee Blackburn, Kaye Ottaway, Brian J Anderson
AIMS: Clonidine may be used intraoperatively to decrease emergence delirium in children, but the drug's impact on postoperative sedation is poorly quantified. METHODS: A prospective audit of children (≤15 years) undergoing (adeno) tonsillectomy or adenoidectomy over a period of 4 months was carried out. All children received sevoflurane for induction and maintenance of anesthesia. The use of clonidine as an adjunct was left to the discretion of the anesthesiologist...
December 2014: Paediatric Anaesthesia
Jonathan R Moss, Shelagh Cofer, Shannon Hersey, Steven Goudy, Jay Werkhaven, Erik Swanson, Christopher Mantle, Nicholas Stowell, Daniel Byrne, Li Wang, Robert Labadie
OBJECTIVE: To determine if pretonsillectomy injection of local anesthetics with and without clonidine reduces pain following tonsillectomy in children. DESIGN: A prospective, randomized, double-blind, placebo-controlled trial. SETTING: Tertiary care academic medical center. PATIENTS: A total of 120 children, ages 3 to 17 years, presenting for tonsillectomy. INTERVENTIONS: Patients were randomized to 1 of 3 pretonsillectomy injection groups: (1) saline, (2) lidocaine plus bupivacaine, or (3) lidocaine plus bupivacaine plus clonidine...
June 2011: Archives of Otolaryngology—Head & Neck Surgery
Omer Lütfi Erhan, Hülya Göksu, Cengiz Alpay, Azize Beştaş
OBJECTIVE: There has yet been no ideal method for postoperative analgesia in children. Ketamine demonstrates a potent analgesic effect by central blockage of perception of pain with sub-anesthetic doses. Preoperative intramuscular administration of ketamine for sedation decreases the pain during swallowing after tonsillectomy, while it provides long-term analgesia when applied around the incision. The aim of this study is to compare the effectiveness of ketamine administered to the tonsillar region following tonsillectomy for postoperative pain management...
May 2007: International Journal of Pediatric Otorhinolaryngology
Peggy E Kelley
PURPOSE OF REVIEW: Even though pediatric tonsillectomy is a well accepted treatment for upper airway obstruction or recurrent tonsillar infection, the painful recovery of this operation is unwelcome. As more studies are published on the beneficial effects of tonsillectomy, the number of tonsillectomies performed is likely to increase. It would behoove any surgeon performing this operation to be aware of the available options for post/perioperative pain control. RECENT FINDINGS: New techniques used to perform tonsillectomy, innovative adjuvant medical therapy and other tools are reviewed...
December 2006: Current Opinion in Otolaryngology & Head and Neck Surgery
H T G Bergendahl, P A Lönnqvist, S Eksborg, E Ruthström, L Nordenberg, H Zetterqvist, E Oddby
BACKGROUND: Clonidine administration in the setting of paediatric anaesthesia is associated with a number of desirable effects, e.g. preoperative sedation, analgesia and reduced anaesthetic requirements. The aim of the current study was to compare postoperative outcome variables using a prospective, randomized, double-blind design after premedication with clonidine or midazolam. METHODS: One hundred paediatric ASA physical status 1 patients (age 1-11 year) scheduled for adeno-tonsillectomy were assigned to receive rectal premedication with midazolam (300 microg kg(-1) and atropine 40 microg kg(-1); group M, n = 52) or clonidine (5 microg kg(-1 and) atropine 40 microg kg(-1); group C, n = 48) prior to a standardized sevoflurane anaesthetic...
November 2004: Acta Anaesthesiologica Scandinavica
I Constant, Y Leport, P Richard, M-L Moutard, I Murat
BACKGROUND: This double-blind randomized study was undertaken to assess agitation, Bispectral Index (BIS) and EEG changes during induction of anaesthesia with sevoflurane in children premedicated with midazolam or clonidine. METHODS: Children were allocated randomly to receive rectal midazolam 0.4 mg kg(-1) (n=20) or oral clonidine 4 microg kg(-1) (n=20) as premedication. Rapid induction of anaesthesia was achieved with inhalation of sevoflurane 8% in nitrous oxide 50%-oxygen 50%...
April 2004: British Journal of Anaesthesia
Katherine O Freeman, Neil Roy Connelly, Donald Schwartz, Barry R Jacobs, Jerry M Schreibstein, Charles Gibson
BACKGROUND: After undergoing tonsillectomy and adenoidectomy (T&A), children may experience significant pain. Clonidine, an alpha2 agonist, exhibits significant analgesic properties. The current investigation sought to determine whether intramuscular (I.M.) clonidine would decrease pain in paediatric patients undergoing T&A. METHODS: Thirty-nine children undergoing elective T&A were studied. Following inhalational anaesthetic induction, fentanyl (2 microg x kg(-1)) was given intravenously, acetaminophen (paracetamol) (30 mg...
September 2002: Paediatric Anaesthesia
Carla Giannoni, Sno White, F Kayser Enneking
OBJECTIVE: The study goal was to determine whether the combination of dexamethasone with preemptive analgesia has an additive effect in further improving recovery. STUDY DESIGN: We conducted a prospective, randomized, double-blinded trial of 50 children undergoing tonsillectomy at a university ambulatory surgery center. One study group received 1 intravenous dose of dexamethasone, and another group received 1 dose of saline solution. All patients received tonsillar fossa injections of ropivacaine plus clonidine before tonsil excision...
March 2002: Otolaryngology—Head and Neck Surgery
C Giannoni, S White, F K Enneking, T Morey
OBJECTIVE: To determine if preemptive analgesia with ropivacaine hydrochloride with or without clonidine hydrochloride decreases pain and hastens recovery after tonsillectomy. DESIGN: Prospective, randomized, triple-blinded trial. SETTING: University referral center; pediatric ambulatory practice. PARTICIPANTS: Sixty-four children, aged 3 to 15 years, undergoing tonsillectomy. INTERVENTIONS: Patients received injections in the tonsillar fossae of isotonic sodium chloride, ropivacaine, or ropivacaine plus clonidine prior to tonsil excision...
October 2001: Archives of Otolaryngology—Head & Neck Surgery
L Fazi, E C Jantzen, J B Rose, C D Kurth, M F Watcha
UNLABELLED: We compared the effects of oral clonidine (4 microg/kg) and midazolam (0.5 mg/kg) on the preanesthetic sedation and postoperative recovery profile in children during tonsillectomy with or without adenoidectomy. In a double-blinded, double-dummy study design, 134 ASA physical status I-II children aged 4-12 yr were randomized to receive a combination of either clonidine and placebo (Group A), or placebo and midazolam (Group B) at 60-90 min and 30 min, respectively, before the induction of anesthesia...
January 2001: Anesthesia and Analgesia
E J Reimer, G S Dunn, C J Montgomery, P M Sanderson, L D Scheepers, P M Merrick
PURPOSE: To compare the analgesic effects of preoperative oral clonidine with intraoperative intravenous fentanyl in children undergoing tonsillectomy or adenotonsillectomy. METHODS: This randomized, controlled, double-blind study of 36 ASA I-II children, age 7-12 yr undergoing adenotonsillectomy was conducted at a tertiary care paediatric teaching hospital. Either 4 clonidine po was given 60-90 min preoperatively or 3 fentanyl i...
December 1998: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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