Prophylactic antiemetic effects of midazolam, dexamethasone, and its combination after middle ear surgery

To evaluate and compare the efficacy of the combination of midazolam and dexamethasone, with midazolam and dexamethasone alone, for the prevention of postoperative nausea and vomiting [PONV] in female patients undergoing middle ear surgery. A prospective, randomized, double-blind, placebo-controlled study in 80 female patients [mean age 32.6 years], undergoing middle ear surgery with general anesthesia at Ohud Hospital, Madina, Kingdom of Saudi Arabia from May 2007 to May 2008. Patients were classified into 4 groups. They received intravenous normal saline [S group], midazolam 0.075 mg/kg [M group], or dexamethasone 10 mg [D group], or a combination of midazolam and dexamethasone [MD group], before the induction of anesthesia. Postoperatively for 24 hours observation and assessment of nausea, vomiting, rescue anti-emetics, and side effects of the study drugs such as headache and drowsiness were carried out. There was a significant difference between the 4 groups. The MD group was the least to develop PONV compared to other groups [p<0.01]. Regarding nausea, there was a non-significant difference between the 4 groups, although the MD group developed the least symptoms among the 4 groups, there were no significant differences in pain intensity and side effects such as, headache, dizziness, and drowsiness between the 4 groups. The combination of midazolam 0.075 mg/kg and dexamethasone 10 mg intravenously is better than either drug alone in reducing the incidence of PONV in female patients after middle ear surgery

Does the use of radio frequency ultrasonic dissector in tonsillectomy have a beneficial effect over the use of laser?

To compare the intra- and post- operative morbidities on the use of radiofrequency ultrasonic dissector [US] with the use of laser during tonsillectomy in the same patients. A randomized comparative study was implemented where all patients underwent tonsillectomy at Al-Hada Armed Forces Hospital, Taif, and Aouhod Hospital, Al-Madinah, Kingdom of Saudi Arabia during the period January 2000 to December 2005 were recruited for the study. Radiofrequency US was used in one side, and laser was used in the other side of the same patient. Intra- and post- operative blood losses, and duration of the operation, in addition to postoperative pain score were recorded. Five hundred and twenty-eight patients were recruited for the study. The mean operation duration was significantly shorter in the US group as compared to the laser group [p < 0.01]. Intraoperative blood loss was significantly lesser in the US group [p < 0.001]. Post-operative pain score was significantly lower among US subjects [p < 0.001]. No significant difference in postoperative hemorrhage was detected between the compared groups. The use of US in tonsillectomy showed a beneficial effect on intraoperative blood loss, duration of the operation, as well as, postoperative pain over the use of laser