Magnesium Gargle versus Ketamine Gargle in Postoperative Sore Throat Pain; A Randomized Placebo-Controlled Clinical Trial

Background: A wide range of approaches have been tested for the prevention and treatment of postoperative sore throat pain (POST pain). This study attempted to compare the effects of gargling with Ketamine or Magnesium Sulfate on POST pain.  Materials and Methods: In a randomized clinical trial, 60 patients scheduled for prone position laminectomy were randomly assigned into three groups: Ketamine (n=20), Magnesium (n=20), and Control (n=20). The Magnesium group received magnesium sulfate gargle (30 mg/kg in a total of 30 ml 5% Dextrose water), the Ketamine group received Ketamine gargle (0.5 mg/kg in a total of 30 ml 5% Dextrose water) and the control group received 30 ml 5% Dextrose water gargle; all these solutions were administered 10 min before anesthesia induction. Visual Analog Scale (VAS) for throat pain was recorded in the recovery room; immediately after arrival and then, at 2, 4, and 24 hours postoperatively in the ward. Would there be any VAS equal to or more than 3 of 10, rescue analgesics were administered immediately and their cumulative doses were recorded.  Results: The incidence of complaint-free patients in the Ketamine group was significantly higher than in the other two groups. The incidence of sore throat with VAS≥3, mandating rescue analgesia, was significantly lower than the other two groups. patient satisfaction after surgery was significantly higher in the Ketamine group.  Conclusion: Patients experiencing POST pain treated with “Ketamine gargle” had better results compared with “Magnesium Sulfate” or “Placebo” gargle.&nbsp

Anesthesia considerations in surgical deep brain stimulation for Tourette syndrome management

Tourette’s syndrome (TS) is a neuro-behavioral disease associated by phonic and motor tics with a high frequency of psychiatric co-morbidities. For these cases, deep brain stimulation (DBS) is a developing neuro-modulated treatment option since the first report on a successful surgery in 1999. A male thirty-one years old (77 kg, 178 cm) with diagnosis of Gilles De La Tourette syndrome admitted to neurosurgery ward. His medication included Aripiprazole, pimozide, buspirone, clomipramine, citalopram, phenytoin, Desmopressin and Lithium. The patient underwent implanting DBS (Deep Brain Stimulator) surgery and battery implantation in two steps with two weeks interval. General anesthesia with considerations and according to behavior of disease and drug interactions was performed. The cause and symptoms may be due to central dopaminergic hyperactivity or anomalous dopamine neurotransmission and interventions and anesthesia should be done considering these abnormalities