Does haloperidol prophylaxis reduce ketamine-induced emergence delirium in children?

Ketamine is a non-barbiturate agent with rapid action onset that induces profound sedation; however, some emergency physicians tend not to use ketamine because of the risk of emergence delirium [ED]. This study aimed to evaluate the effectiveness of haloperidol prophylaxis in postoperative ketamine delirium in children. Prospective data relating to any emergence dreams, delirium, hallucinations, agitation, crying, altered perceptions, and necessary interventions were recorded in consecutive cases of ketamine delirium in patients attending Mansoura University Hospital, Egypt, from June 2010 to May 2011. A total of 537 records were available for analysis. Of those, 267 received prophylactic haloperidol [49.7%]. There were significant differences between the two groups regarding post-anaesthetic care unit behaviour. The ketamine-haloperidol groups included more patients who were sleepy, calm [P

Role of water soluble contrast agents in assigning patients to a non-operative course in adhesive small bowel obstruction

Adhesive small bowel obstruction [SBO] is a common surgical emergency. It is estimated that at least 60% of SBO are due to post-operative adhesions. Water soluble contrast agents [gastrografin] have been used to identify patients who might be treated non-operatively. This study aims to determine the role of gastrografin in adhesive intestinal obstruction patients. In this prospective study, 27 patients admitted between 1[st] August 2004 and 1[st] July 2006 with clinical signs suggestive of postoperative adhesive SBO met the inclusion criteria. After intravenous hydration, nasogastric tube insertion and complete suctioning of the gastric fluid, 100 ml of gastrograsfin was given and plain abdominal radiography was taken 6 hours and 24 hours if the contrast is not seen in the colon. Those in whom the contrast reached the colon in 24 hours were considered to have partial SBO and started oral intake. If gastrografin failed to reach the colon in 24 hours and the patient did not improve in the following 24 hours, laparotomy was performed. Conservative treatment was successful in 31 cases [91%] and 3 [9%] required operation. Patients treated conservatively had short hospital stay [mean=4 days] and tolerated oral feeding with no morbidity or mortality. Oral gastrografin helps in the management of patients with postoperative adhesive SBO