Does the addition of nitrous oxide improve sevoflurane induction of anesthesia in children?

Recently, with the introduction of sevoflurane and owing to its ease and speed of induction together with the lack of the pungent irritating odour, all these factors made sevoflurane ideal for inhalation induction in children. Nitrous oxide was known to augment the effect of all inhaled anesthetic agents. The present study tested the hypothesis that N[2]O could facilitate induction and tracheal intubation conditions with 8% sevoflurane in children. The study included 60 children aged 3-10 years divided into 3 groups to undergo inhalation induction with 8% sevoflurane in 50% N[2]O, 66% N[2]O, and 100% oxygen for the three involved groups. Induction time was shortest in group II [66% N[2]O] [46.4 +/- 6.08 s] and longest in group III [100% O[2]] [72. 75 +/- 11.09 s]. Intubation conditions were best in group II with the least complication rate [15%] while group III reported 60% complication rate. Hemodynamically, no clinically important changes were recorded. The study concluded that the use of inhalation induction with 8% sevoflurane in 66% N[2]O was safe in a sense of fast and least eventful induction with easy and favourable intubating conditions in children undergoing elective surgery

Clinical evaluation of intraperitoneal bupivacaine, or combined with morphine and pethidine for analgesia after laparoscopic gynecologic procedures

Pain after laparoscopic gynecology is an important factor that increases hospital admission after day-case laparoscopy. The study compared the postoperative analgesic effect of intraperitoneal instillation of bupivacaine, bupivacine + pethidine, bupivacaine + morphine and saline in 48 patients after laparoscopic gynecologic procedures. Each group had 12 patients. The study showed that in the pethidine added group, the duration of analgesia was longest with the lowest VAS scores and the least side-effects. Adding morphine to bupivacaine added no clinically additional analgesic advantage, however, it increased the incidence of side-effects. The study concluded that intraperitoneal instillation of 20 ml. of 0.5% bupivacaine + 100 mg. pethidine after laparoscopic gynecologic procedures proved simple, safe, effective technique with minimal side-effects and is recommended to be applied at the designated sites at the end of gynecologic laparoscopy

Clinical evaluation of 2 years experience of epidural analgesia for labor: a retrospective study

The use of epidural analgesia [EA] for labour was introduced to clinical practice in 1931 hesitantly. By time, this method of pain relief has become the first choice for many labouring women. This retrospective study was planned to assess the degree of patient's satisfaction and the incidence of side effects related to EA for labour which was done in United Doctors Hospital in Jeddah over 2 years period. The study demonstrated that maternal satisfaction was affected by maternal age, weight, the source of information about EA, previous experience with epidurals before and the length of delivery. AE did not affect the rate of caesarean delivery and the fetal outcome was excellent. Side-effects recorded included: backache, itching, shivering and vomiting. The overall satisfaction with EA was 93.3% which was comparable to results from other institutions. Epidural analgesia for labour is a well established method of pain relief during labour and should be encouraged to be practiced by anesthetists and to be accepted by more patients as well