Morphine-midazolam combination dose for presurgical analgesia in children

We have examined the use of presurgical morphine-midazolam combination in 80 children aged 2-10 y undergoing repair of hypospadias. They were allocated randomly, in a double-blind study, to receive one of four morphine-midazolam combination doses [n = 20 each]; [group I: 76 mg/kg each] [group II: 75 mg/kg morphine, 50 mg/kg midazolam]; [group III: 50 mg/kg morphine, 75 mg/kg midazolam]; [group IV: 50 mg/kg each]. Drugs were given after induction of anesthesia and before the start of surgery. Observational scoring system, using crying, movement, agitation, posture and localization of pain as scoring criteria, was used to assess the children during their stay in the recovery room together with their sedative and/or analgesic requirement. Pre-surgical morphine-midazolam administration produced stable hemodynamic variables with satisfactory postoperative analgesia suggesting 75 mg/kg dose of both morphine and midazolam as upper permissible dose, and 50 mg/kg each as lower effective dose

Spinal versus epidural anesthesia during transurethral resection of the prostate+

The operative superiority of epidural anesthesia during transurethral resection of the prostate [TURP] stimulated this study. Twenty patients scheduled for TURP were randomly allocated to receive either spinal anesthesia [n = 10] with 8 ml bupivacaine 0.5% + 5ml lignocaine 2%. During and after the operative procedure PR, BP, ECG, and pulse oximetry were monitored, and blood Hb and Hct, plasma free Hb, and serum sodium and potassium levels were measured. Both techniques resulted in similar PR and BP changes. TURP with spinal anesthesia resulted in more prolonged period of hyponatremia and more increased duration of raised plasma free Hb

Mean arterial blood pressure and heart rate changes during supine and lateral positions under different anesthetic techniques

The effect of supine and lateral positions and different anaesthetic techniques on mean arterial blood pressure and pulse rate were studied for 40 patients submitted at MUNC for kidney operations, between the age of 20-40 years. The results of this study indicated that: the non-depolarizing muscle relaxant d-tubocurarine caused a significant hypotension in the supine position. In the mean time halothane administration was associated with marked hypotension in the supine position that was exaggerated in the lateral position. No significant effect on the pulse rate was displayed whether in the supine or the lateral position