Ondansetron pretreatment reduces pain on injection of Propofol

To assess the effectiveness of ondansetron pretreatment in alleviating propofol injection pain, 135 patients were randomly assigned to one of following three groups. Group 1 who received up to 2 mL pretreatment 50 mg tramadol in the saline, group 2 cases who received up to 2 mL pretreatment 4 mg ondansetron in saline, and group 3 who received up to 2 mL solution saline. A 20 gauge cannula was placed into the largest vein on the dorsum of the hand. Tourniquet was closed to the arm above the cannula and inflates to 70 mmHg, and then drug was injected. After 20 seconds, the tourniquet deflated, and propofol 2mg/kg injected over 10 seconds and pain assessment was made. Tramadol and ondansetron significantly reduced the incidence and severity of propofol injection pain more than placebo [P=0.001]. The efficacy of ondansetron in alleviating the pain on injection of propofol was no different from tramadol [P=0.330]. Ondansetron pretreatment may be used to reduce the incidence of pain on injection of propofol, an advantage added to the useful prevention of postoperative nausea and vomiting

[Systemic side-effects of topical ophthalmic drops in a 17-year old boy candidate for deep viterectomy: a case report]

Drugs applied topically to the eye may be absorbed systemically to a substantial degree, with the potential to cause serious systemic side-effects. Children may be particularly vulnerable to systemic effects of topically applied agents as topical doses are often not weight-adjusted. This article describes a case of serious systemic side-effect by the use of topical phenylephrine, tetracaine, tropicamide and atropine in a 17-year old boy candidate for deep viterectomy in Farabi Hospital in 1389. Following application of the aforesaid eye drops, the patient developed hypertension and subsequent loss of conciseness. Several types of eye drops and their repeated use can lead to their systemic absorption and medical complications due to overdose. Strategies to minimize systemic absorption should be applied, including use of low concentrations of ophthalmic drugs, administration of one type of the drug, use of microdrops and punctal occlusion to minimize absorption via the nasolacrimal duct. While administering ophthalmic drops, one should take these precautions to minimize the systemic effects of the drugs to prevent subsequent complications

Prevention of propofol injection pain with small-dose ketamine

Propofol is a popular IV anesthetic induction drug that causes pain when given IV, the incidence of which is between 28%-90%. We plan to determine the optimal dose of ketamine in the prevention of propofol injection pain and compare it with lidocaine, the commonly proposed pre-treatment. In a double-blind randomized study 500 Patients [ASA I,II] scheduled for elective strabismus surgery under general anesthesia were randomly allocated into five groups. After obtaining the informed consent., patients received normal saline [Group NS], lidocaine 1mg.kg[-1] [Group L], and different doses of ketamine 50-75-100 micro g.kg[-1] [Group K50-K75-K100 respectively], immediately before the injection of 2.5 mg.kg[-1] propofol. Each patient's pain scores were measured at five seconds intervals by a blinded anesthesiologist. Statistical analysis were made by SPSS vs 11.5. The incidence and intensity of pain in all study groups were significantly lower than placebo group [Group NS] [P<0.005]. Patients in the K100 Group had significantly lower incidence of pain and lower pain scores compared with the K50 and L Groups [P<0.001]. There were no significant differences in hemodynamic parameters between groups. Administration of ketamine 100 micro g.kg[-1] immediately before propofol injection is a safe and effective method in preventing propofol injection pain

Fucosidosis and anesthesia

storage disorder caused by a severe deficiency of a-L-facosida.se. Patients usually have some problems with glycoprotein storage in the brain and other organs, and some structural abnormalities that need special consideration in anesthesia. It has 2 types, the early onset or infantile, and the juvenile. Here we present an 8-year old girl with deformities in the maxillofacial region, with big tongue, small and retracted chin, saddle nose, and short neck that could not be extended, causing difficult intubation, and congenital cardiac problems requiring a special anesthetic strategy