Deep versus awake removal of the laryngeal mask air way in children

We studied 74 children aged 1-10 years undergoing short elective surgical procedures with general anesthesia supplemented by regional anesthesia. Patients were randomly allocated to have the laryngeal mask air way removed either upon awakening or while anesthetized. Subsequent observation of respiratory factors and oxygen saturation showed a significant difference between the groups for coughing, with a greater incidence [50%] in the awake group compared with those where the laryngeal mask air way was removed while anesthetized [7.5%]. There ware clinical but not statistical differences in the incidence in laryngospasm, desaturation and excess salivation between the groups. We conclude that removal of the laryngeal mask airway during deep anesthesia reduced coughing in the immediate post operative period

effect of preoperative intravenous dexamethasone in pediatric adenotonsillectomy

This study aimed at evaluating the efficacy of a single dose of preoperative dexamethasone on adenotonsillectomy postoperative nausea, vomiting, and oral intake. One hundred twenty children aged 4-14 years underwent adenotonsillectomy in Prince Rashed Hospital in Jordan, from January 1998 to March 1999. Sixty two chidren [51.7%] received dexamethasone preoperatively where 58 children did not [48.3%]. All children were observed for postoperative oral intake, vomiting, temperature and complications. Children who received intravenous dexamethasone had signifncantly less vomiting [4.8% vs 15.5%], elevation of temperature 6 hours [3.25% vs 15.5%] after surgery and more oral intake [620 ml vs 410 ml], liquid and soft diet at 24 hours [40.3% vs 18.9%]. Dexamethasone significantly decreased the incidence of postoperative nausea and vomiting in the twenty four hours after discharge with improved oral intake