Journal of Yeungnam Medical Science

Original article

Enhancing ketamine anesthesia with midazolam and fentanyl for children’s ear surgery: a prospective randomized study: Seong Min Han, So Young Kwon, Jang Hyeok In, Jin Deok Joo; J Yeungnam Med Sci. 2024;41(3):207-212. Published online May 23, 2024; DOI: https://doi.org/10.12701/jyms.2024.00276

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Abstract PDF: Background
Myringotomy with tympanostomy tube insertion (MTI) is a superficial surgical procedure used to prevent hearing loss in children with serous otitis media. Intravenous anesthesia, often ketamine, is preferred for this procedure because of its ability to induce sedation without compromising airway reflexes. However, ketamine alone may be insufficient and potentially lead to spontaneous movement during surgery. This study evaluated the effectiveness of midazolam and fentanyl as adjuvants to ketamine in reducing spontaneous movement during MTI and enhancing the quality of recovery.
Methods
This study involved two groups of 30 patients each: one group received intravenous ketamine (1.5 mg/kg) with an equal volume of normal saline (K group), while the other received a combination of midazolam, fentanyl, and ketamine (0.05 mg/kg, 1 μg/kg, and 1.5 mg/kg, respectively; MFK group). We assessed side effects, intraoperative patient movement, surgeon satisfaction, and emergence agitation scores.
Results
The MFK group exhibited significantly lower scores for patient movement (p<0.01) and emergence agitation (p<0.01) and markedly higher surgeon satisfaction scores (p<0.01) than the K group.
Conclusion
Administering a midazolam-fentanyl-ketamine combination effectively reduced spontaneous movement during surgery and emergence agitation during recovery without prolonging discharge times in children undergoing MTI.

Original Article

Risk factors for persistent otitis media with effusion in children: a case-control study: Ju Yeon Lee, Se-Hyung Kim, Chan Il Song, Young Ree Kim, Yoon-Joo Kim, Jae Hong Choi; Yeungnam Univ J Med. 2018;35(1):70-75. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.70

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3 Crossref

Background
Otitis media with effusion (OME) is defined as middle ear effusion without acute signs of infection. OME usually resolves spontaneously; however, persistent OME may require the insertion of a ventilation tube. This study investigated risk factors for persistent OME in children who undergo ventilation tube insertion.
Methods
Children who were admitted to undergo ventilation tube insertion at Jeju National University Hospital between August 2015 and July 2016 were enrolled as the case group. Healthy children without persistent OME from August 2016 to July 2017 were enrolled as the control group. Baseline characteristics and predisposing factor data were collected using an interview questionnaire. Middle ear fluids were collected from the case group.
Results
A total of 31 patients underwent ventilation tube insertion. The mean age of the case group was 4.53 years, with a male-to-female ratio of 21:10. Twenty-nine (93.5%) children attended a daycare center, and 21 (67.7%) had experience with bottle feeding. Fifteen (48.4%) children in the case group and 3 (9.7%) in the control group first attended a daycare center at <1 year of age (odds ratio=9.96; 95% confidence interval=2.44-39.70; p=0.001). No bacteria were found in middle ear fluid collected from the 31 operated children. Nasopharyngeal bacterial colonization was found in 13 (41.9%) and 17 (54.8%) children in the case and control groups, respectively.
Conclusion
Earlier attendance at a daycare center was the only predisposing factor for ventilation tube insertion in our study. The aseptic nature of middle ear fluids found in children with OME highlights the efficacy of antimicrobial use.

Citations

Citations to this article as recorded by

Otitis Media With Effusion After the COVID‐19 Pandemic: Return to the Past and New Lessons
Mirko Aldè, Paola Marchisio, Francesco Folino, Umberto Ambrosetti, Federica Di Berardino, Stefania Barozzi, Diego Zanetti, Lorenzo Pignataro, Giovanna Cantarella
Otolaryngology–Head and Neck Surgery.2024; 171(3): 724. CrossRef
Impact of COVID-19 on nationwide pediatric otolaryngology: Otitis media and myringotomy tube trends
David Z. Allen, Sai Challapalli, Sean McKee, Kyung Hyun Lee, Cynthia S. Bell, Soham Roy, Sarah Bowe, Karthik Balakrishnan, C.W. David Chang, Zhen Huang
American Journal of Otolaryngology.2022; 43(2): 103369. CrossRef
Special Considerations for Tympanoplasty Type I in the Oncological Pediatric Population: A Case-Control Study
Celine Richard, Emily Baker, Joshua Wood
Frontiers in Surgery.2022;[Epub] CrossRef

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