Intramuscular Ketamine Effect on Postnasal Surgery Agitation: A Prospective Double-Blinded Randomized Controlled Trial

This study investigates the effect of intramuscular ketamine on emergence agitation (EA) following septoplasty and open septorhinoplasty (OSRP) when administered at subanesthetic doses at the end of surgery. A random sample of 160 ASA I-II adult patients who underwent septoplasty or OSRP between May...

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Main Authors: Husam A. Almajali, Ali M. Abu Dalo, Nidal M. Al-Soud, Ali Almajali, Abdelrazzaq Alrfooh, Thani Alawamreh, Hamza Al-Wreikat
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:Anesthesiology Research and Practice
Online Access:http://dx.doi.org/10.1155/2023/2286451
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author Husam A. Almajali
Ali M. Abu Dalo
Nidal M. Al-Soud
Ali Almajali
Abdelrazzaq Alrfooh
Thani Alawamreh
Hamza Al-Wreikat
author_facet Husam A. Almajali
Ali M. Abu Dalo
Nidal M. Al-Soud
Ali Almajali
Abdelrazzaq Alrfooh
Thani Alawamreh
Hamza Al-Wreikat
author_sort Husam A. Almajali
collection DOAJ
description This study investigates the effect of intramuscular ketamine on emergence agitation (EA) following septoplasty and open septorhinoplasty (OSRP) when administered at subanesthetic doses at the end of surgery. A random sample of 160 ASA I-II adult patients who underwent septoplasty or OSRP between May and October, 2022, was divided into two groups of eighty patients each: ketamine (Group K) and saline (Group S) with the latter serving as the control group. At the end of surgery immediately after turning off the inhalational agent, Group K was administered with intramuscular 2 ml of normal saline containing 0.7 mg/kg ketamine and Group S with 2 ml of intramuscular normal saline. Sedation and agitation scores at emergence from anesthesia were recorded after extubation using the Richmond Agitation-Sedation Scale (RASS). The incidence of EA was higher in the saline group than in the ketamine group (56.3% vs. 5%; odds ratio (OR): 0.033; 95% confidence interval (CI): 0.010–0.103; p<0.001). Variables associated with a higher incidence of agitation were ASA II classification (OR: 3.286; 95% (CI): 1.359–7.944; p=0.008), longer duration of surgery (OR: 1.010; 95% CI: 1.001–1.020; p=0.031), and OSRP surgery (OR: 2.157; CI: 1.056–5.999; p=0.037). The study concluded that the administration of intramuscular ketamine at a dose of 0.7 mg/kg at the end of surgery effectively reduced the incidence of EA in septoplasty and OSRP surgery.
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spelling doaj-art-e427f145208d4affae94fb094bfaa0d42025-08-20T02:21:34ZengWileyAnesthesiology Research and Practice1687-69702023-01-01202310.1155/2023/2286451Intramuscular Ketamine Effect on Postnasal Surgery Agitation: A Prospective Double-Blinded Randomized Controlled TrialHusam A. Almajali0Ali M. Abu Dalo1Nidal M. Al-Soud2Ali Almajali3Abdelrazzaq Alrfooh4Thani Alawamreh5Hamza Al-Wreikat6Department of Anaesthesia and Intensive CareDepartment of Anaesthesia and Intensive CareDepartment of Anaesthesia and Intensive CareDepartment of Anaesthesia and Intensive CareDepartment of ENTDepartment of Anaesthesia and Intensive CareDepartment of Anaesthesia and Intensive CareThis study investigates the effect of intramuscular ketamine on emergence agitation (EA) following septoplasty and open septorhinoplasty (OSRP) when administered at subanesthetic doses at the end of surgery. A random sample of 160 ASA I-II adult patients who underwent septoplasty or OSRP between May and October, 2022, was divided into two groups of eighty patients each: ketamine (Group K) and saline (Group S) with the latter serving as the control group. At the end of surgery immediately after turning off the inhalational agent, Group K was administered with intramuscular 2 ml of normal saline containing 0.7 mg/kg ketamine and Group S with 2 ml of intramuscular normal saline. Sedation and agitation scores at emergence from anesthesia were recorded after extubation using the Richmond Agitation-Sedation Scale (RASS). The incidence of EA was higher in the saline group than in the ketamine group (56.3% vs. 5%; odds ratio (OR): 0.033; 95% confidence interval (CI): 0.010–0.103; p<0.001). Variables associated with a higher incidence of agitation were ASA II classification (OR: 3.286; 95% (CI): 1.359–7.944; p=0.008), longer duration of surgery (OR: 1.010; 95% CI: 1.001–1.020; p=0.031), and OSRP surgery (OR: 2.157; CI: 1.056–5.999; p=0.037). The study concluded that the administration of intramuscular ketamine at a dose of 0.7 mg/kg at the end of surgery effectively reduced the incidence of EA in septoplasty and OSRP surgery.http://dx.doi.org/10.1155/2023/2286451
spellingShingle Husam A. Almajali
Ali M. Abu Dalo
Nidal M. Al-Soud
Ali Almajali
Abdelrazzaq Alrfooh
Thani Alawamreh
Hamza Al-Wreikat
Intramuscular Ketamine Effect on Postnasal Surgery Agitation: A Prospective Double-Blinded Randomized Controlled Trial
Anesthesiology Research and Practice
title Intramuscular Ketamine Effect on Postnasal Surgery Agitation: A Prospective Double-Blinded Randomized Controlled Trial
title_full Intramuscular Ketamine Effect on Postnasal Surgery Agitation: A Prospective Double-Blinded Randomized Controlled Trial
title_fullStr Intramuscular Ketamine Effect on Postnasal Surgery Agitation: A Prospective Double-Blinded Randomized Controlled Trial
title_full_unstemmed Intramuscular Ketamine Effect on Postnasal Surgery Agitation: A Prospective Double-Blinded Randomized Controlled Trial
title_short Intramuscular Ketamine Effect on Postnasal Surgery Agitation: A Prospective Double-Blinded Randomized Controlled Trial
title_sort intramuscular ketamine effect on postnasal surgery agitation a prospective double blinded randomized controlled trial
url http://dx.doi.org/10.1155/2023/2286451
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