Document Type : Original Research
Authors
1
Resident of Anesthesia, Surgical Intensive Care and Pain Management, Cairo university, Egypt.
2
Lecturer of Anesthesia, Surgical Intensive Care and Pain Management, Cairo university, Egypt.
3
Faculty of pharmacy cairo university (clinical pharmacy program)
4
Department of Anesthesiology, Surgical ICU and Pain Management, Armed forces College of Medicine, Cairo, Egypt.
5
Professor of Anesthesia, Surgical Intensive Care and Pain Management, AFCM
Abstract
Background
In the literature, Postoperative sore throat (POST) is a frequently occurring challenge after
pediatric tonsillectomy, significantly impacting recovery and Comfort of the patient.
This study was conducted to compare the effect between Nebulized Dexmedetomidine, Ketamine and Magnesium to reduce POST in pediatrics.
Methods:
A blind clinical trial study was conducted at Al-Maadi Military Hospital, 192 pediatric patients were randomized into three groups, each receiving a preoperative nebulization dose: Ketamine (0.75 mg/kg), Magnesium Sulfate (250 mg), or Dexmedetomidine (2 mcg/kg).
POST severity was assessed after surgery (0, 2, 4, 8, 12, and 24 hours) using a validated four-point scale. The age of ASA physical status I and II tonsillectomy patients of either sex was 5–8.
Results:
The results revealed Dexmedetomidine (Group D) as the most effective agent in reducing both the incidence and severity of POST across all time points.
At 8 hours post-operation, only 12.5% of patients in Group D experienced POST in comparison
to 37.5% in Group K and 29.7% in Group M. Furthermore, by 24 hours, POST incidence in Group D was reduced to 3.1%, demonstrating a statistically significant advantage (p < 0.05).
The study also noted that Dexmedetomidine provided better hemodynamic stability and lower intraoperative analgesic requirements compared to Ketamine and Magnesium Sulfate.
Conclusion:
This study underscores the potential of Dexmedetomidine as an optimal preoperative nebulized treatment for managing POST in pediatric tonsillectomy patients. Its superior efficacy, coupled with minimal side effects, positions it as a valuable approach in improving postoperative recovery and parental satisfaction.
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