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Articles by H. J Kwak
Total Records ( 2 ) for H. J Kwak
  H. J Kwak , S. K Min , J. S Kim and J. Y. Kim
  Background

Pain from a propofol injection is a common side-effect in paediatric patients. This prospective, randomized, double-blind study evaluated the efficacy of a combined pretreatment of alfentanil with lidocaine on the incidence and severity of propofol injection pain in children.

Methods

After obtaining parental consent, 120 paediatric patients were allocated randomly into one of the three groups (n=40, in each). The patients in the alfentanil group received alfentanil 15 µg kg–1 90 s before the propofol injection. The patients in the lidocaine group received propofol 3 mg kg–1 premixed with lidocaine 0.1% over a 15 s period. The patients in the combination group received both alfentanil and lidocaine.

Results

The incidence of propofol injection pain (severity 2 or more) in the combination group (2.6%) was significantly lower than that in the alfentanil and lidocaine groups (30% and 38.5%, respectively) (P=0.001 and <0.001, respectively). No patient in the combination group complained of moderate or severe pain from propofol injection.

Conclusions

Our study demonstrated that the combination treatment of two different analgesic modalities, alfentanil and lidocaine, could prevent the moderate and severe pain on propofol injection, and reduce the incidence of mild pain compared with each drug alone.

  H. J Kwak , J. Y Kim , S. K Min , J. S Kim and J. Y. Kim
  Background

The goals of this study were to determine the effective bolus dose of alfentanil required for successful tracheal intubation during inhalation induction using sevoflurane 5% without neuromuscular block in children, and whether nitrous oxide reduces these doses.

Methods

Fifty paediatric patients, aged 3–10 yr, were randomly assigned to one of the two groups. Subjects received either sevoflurane 5% in oxygen 100% (O2 group, n=25) or sevoflurane 5% in oxygen 40% and nitrous oxide 60% (N2O group, n=25) through a face mask. One minute after inhalation induction, a predetermined dose of alfentanil was injected over 15 s. The alfentanil dose was determined using Dixon's up-and-down method, starting from alfentanil 14 µg kg–1. The trachea was intubated 3 min after inducing anaesthesia.

Results

The ED50 [95% confidence interval (CI)] of alfentanil for successful tracheal intubation was 11.5 (9.9–13.1) and 8.6 (7.4–9.8) µg kg–1 in the O2 and N2O groups, respectively. The ED50 of the N2O group was significantly lower than that of the O2 group (P=0.0146). From isotonic regression, 50% effective dose (ED50) (95% CI) of alfentanil in the O2 and N2O groups was 11.4 (9.9–13.0) and 6.5 (5.0–8.1) µg kg–1, respectively.

Conclusions

The effective bolus dose of alfentanil for successful tracheal intubation was 11.5 µg kg–1 in 50% of children during inhalation induction using sevoflurane 5% without neuromuscular blocking agent. Addition of nitrous oxide 60% in oxygen reduced the effective alfentanil dose by 25%.

 
 
 
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