Notice bibliographique
Résumé
We thank Dr. Fregene for her interest in our study 1. Her concern with respect to interpretation of the results of postoperative pain scores is justified. Our study was not designed to evaluate the impact of any possible peri-operative analgesic effects of magnesium sulphate on the incidence of emergence agitation. We intended to evaluate the modulatory effects of magnesium sulphate on the intrinsic direct central nervous system effects of sevoflurane that may contribute to the development of emergence agitation 2. The primary outcome measure of the study was the difference in the incidence of emergency agitation and the study was only powered to detect this difference. The role of intra-operative magnesium sulphate as an analgesic adjuvant has been extensively studied in adults with recent good evidence supporting its favourable peri-operative analgesic effects 3, 4. In contrast, there is a paucity of published reports investigating the analgesic potentials of magnesium sulphate in children and the results of adult studies cannot be extrapolated to children. Postoperative pain has been suggested as a possible contributing factor to emergence agitation 5. However, emergence agitation can occur in pain-free children undergoing diagnostic radiological procedures 6. Therefore, postoperative pain appears to be an aggravating, not an independent, aetiological factor. It has been recommended that postoperative pain be removed from the emergence agitation equation through the use of adequate postoperative analgesia 7 and this was our rationale for administering incremental doses of fentanyl to manage postoperative pain and emergence agitation. Pain is a subjective experience and it is important to ensure that younger children are competent to provide reliable information on the quality and intensity of their postoperative pain. The Association of Paediatric Anaesthetists of Great Britain and Ireland recently recommended the use of an observational measure in conjunction with self-reporting in pre-school children 8. A rigorous systematic review of behavioural measures of pain concluded that the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) had the highest level of evidence to support its use in children 9. Dr. Fregene suggests that the use of additional intraoperative analgesia might obviate the observed difference in agitation scores. Administration of variable doses of fentanyl intra-operatively 10 and at the end of anaesthesia 11 is associated with a significant reduction in the incidence of emergence agitation. However, a recent meta-analysis 12 concluded that the analgesic properties of fentanyl, ketamine and α2-adrenergic receptor agonists are unlikely to be involved in preventing emergence agitation in children.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».