Ketofol performance to reduce postoperative emergence agitation in children undergoing adenotonsillectomy

Figures & data

Table 1. Demographic characteristics, intraoperative managements, and recovery times

Demographic data	Set A (n = 60)	Set B (n = 60)	P value
Age (year)	12.5 ± 3.1	12.3 ± 3.4	0.2
Weight (kg)	29.5 ± 7.7	27.8 ± 7	0.1
Body mass index (kg/m^2)	17.6 ± 1.3	17.3 ± 1.6	1.0
Gender (M/F)	31/29	32/28	0.2
Recovery times (min)	15.5 ± 4.1*	11.6 ± 3.0	0.008
Duration of surgery (min)	63.8 ± 19.3	62.6 ± 18.0	0.1
Duration of mental orientation (min)	37.9 ± 8.0	40.2 ± 9.6	0.9
Sick individuals with tension score 4 during postoperative 1-h period (n) (%)	27 (45)	22 (36.6)	0.3
The consumption of anesthetics (mg)	52.7 ± 18.5*	157.6 ± 85.6	0.0001
The consumption of antiemetic (Emedur, mg, amp)	6.0 ± 26.4*	19.0 ± 43.5	0.004
Time of ambulation (min)	16.5 ± 5.5	8.6 ± 5.7*	0.005
Ready for discharge (min)	25.7 ± 10.9	15 ± 7.8*	0.001
Time to actual discharge (min)	39.4 ± 12	25.6 ± 7.9*	0.001

Set A (non-ketofol group), set B (ketofol treated group)

Table 2. Scores and analgesic requirements of the sets

Requirements	Set A	Set B	P value
The time of oculocardiac reflex (OCR) (num)	32	14*	0.001
Preoperative tension score	5.7	4.8*	0.4
Postoperative tension score during awakening	19	5 *	0.005
Faces Pain Scale during awakening	5	2*	0.001
Ramsay Sedation Score during awakening	50	0.9 *	0.01
Ramsay Sedation Score at postoperative 60th min	3	4*	0.02
Postoperative (numeric rank score)	3	0.5*	0.005
Postoperative sore throat (n) (%)	25 (41.6)	17 (28.3)	0.03
The analgesic requirement during 1-hourpostoperative period (n) (%)	19 (31.7)	14 (23.3) *	0.002
The satisfaction score of surgeons during procedure	1	3	0.07

Table 3. Paediatric Anesthesia Sudden Delirium (PAED) score

Behaviour	Not at all	Just a little	Quite a bit	Very much	Extremely
Makes eye contact	2	4	3	1	0
Actions are purposeful	2	3	1	1	0
Aware of surroundings	4	2	3	1	0
Restless	2	1	2	3	4
Inconsolable	4	2	3	3	4

1, calm; 2, not calm but could be easily consoled; 3, moderately agitated or restless and not

easily calmed; 4, combative, excited, thrashing around

Table 4. Paediatric Anesthesia Sudden Delirium scale and pain score

	Ketofol	Without ketofol
	N = 60	N = 60
PAED scale at awakening	3 (0–23) *	10 (0–32)
PEAD peak score Tension, PEAD score >10 (%)	7 (0–29) * 8/60 (13.33%) *	14 (7–35) 29/60 (48.33%)
Sever tension, PEAD score 15 (%) OPS maximum score (range)	5/60 (8%) * 3 (1–13) *	9/60 (15%) 6 (1–17)
OPS >4 (%)	10 (16.6%) *	39 (65%)

The median of OPS maximum score: range (minimum–maximum). PAED = pediatric anesthesia sudden delirium; OPS = objective pain score. P < 0.05.

Figure 1. Performance of ketofol on the heart rate and arterial pressure in comparison to untreated set. (a) Heart rate (beat/min). (b) Arterial pressure measures (mmHg). Data were presented as mean rate. ** P value ≤0.01

Figure 2. Investigation of expected complications under ketofol administration. (a) Cardiovascular complications. (b) Physiological complications. (c) Uncomfortable complications. ** P value ≤0.001

Figure 3. Data on ventilation rates under the effect of ketofol at children anesthesia. (a) Respiratory rate (breath/min). (b) Oxygen saturation percentage (%). (c) Postoperative observations. ** P value ≤0.01, * P value ≤0.05