A network meta-analysis of 70 studies with 7617 children compared 19 perioperative medications for preventing emergence agitation after sevoflurane anesthesia. Dexmedetomidine, propofol, midazolam, fentanyl, nalbuphine, and ketamine significantly reduced the incidence of emergence agitation. The analysis ranked drugs by effectiveness, with these six showing the most favorable preventive effects. The findings support evidence-based choices for pediatric anesthesia practice.
A meta-analysis of ten randomized controlled trials involving 593 patients found that gargling with ketamine before surgery significantly reduced the incidence of sore throat at 0, 2, 4, 8, and 24 hours after endotracheal intubation for general anesthesia, compared to a placebo. The odds of sore throat were 86% lower immediately after surgery and remained 64% lower at 24 hours. Ketamine gargle did not shorten anesthesia time. The analysis suggests that this simple, low-cost intervention can effectively prevent postoperative throat pain.