Evaluation of different anaesthetic techniques for insertion of laryngeal mask airway in cardiac patients undergoing urgent retinal surgery

Forty-five ASA I and II adult patients scheduled for urgent retinal surgery were included in the study after giving a written informed consent. Patients were randomly divided into three equal groups; 15 patients each: Group P [propofol group], group S [sevoflurane group] and group MT [midazoIam-thiopentone group]. Induction of anaesthesia was done by propofol in group P in a dose of 3 mg.kg[-1] while 8% sevoflurane in 50% nitrous oxide in oxygen was used for induction in group S. In-group MT, midazolam was given iv in a dose of 0.1 mg.kg[-1] followed after three minutes with thiopentone in a dose of 5 mg.kg[-1]. The laryngeal mask airway [LMA] was inserted using the standard method described by Brain. The three groups were comparable as regards age, weight, gender and type of surgical procedures. There were significant decrease in heart rate, MABP, and CI compared with baseline values in group P and group MT [P<0.05]. There was insignificant difference between the three groups as regards percentage of patients with excellent to satisfactory quality of LMA insertion being 90%, 85%, and 95% in group P, S, and MT respectively. Time of insertion of LMA was significantly shorter in propofol group compared with the other two groups [P<0.001]. The number of attempts of insertion of LMA was significantly higher in sevoflurane group. The percentage of patients who received additional propofol doses was significantly less in sevoflurane group compared with other two groups [P<0.05]. During trial of insertion of LMA, it was successfully inserted in high percentage of patients in the first minute in both propofol and midazolam-thiopentone groups compared with sevoflurane group [P<0.001]. The incidences of cough, laryngeal spasm and inadequate jaw relaxation were higher while the duration of apnoea was significantly shorter in sevoflurane group compared with the other two groups [P<0.001]. There was insignificant difference between the three groups as regards the incidences of hiccough, head movement, and bronchospasm. It could be concluded that the use of sevoflurane-N[2]O for insertion of LMA in cardiac patients was associated with greater degree of haemodynamic stability. The ease and quality of insertion of LMA was comparable between the three groups. The time for insertion of LMA using sevoflurane -N[2]O was longer but the incidence of respiratory depression was less compared with the other two groups

Fetal nuchal translucency ultrasound screening for Down syndrome during the first trimester of pregnancy

Down syndrome is the commonest cause of severe mental retardation in children. First trimester screening for nuchal translucency ultrasonographically was performed on 1552 women with singleton pregnancies at 10-14 weeks of gestation. The age of women ranged from 16-43 years. The results showed nine cases with increased thickness of nuchal skin >3 mm with a percentage of [0.58%] of total cases. Seven of these nine cases had abnormal chromosomes by karyotyping [77.78%]. Five cases from the seven cases with abnormal chromosomes had trisomy 21 [Down syndrome] which was [71.4%]. Two women of those who had increased nuchal translucency were euploid. Down syndrome is an age-related disorder. Combination of nuchal translucency ultrasound screening with serum screening is recommended for early diagnosis of Down syndrome in the first trimester of pregnancy

Fluid resuscitation in moderately and severely burned children: analytical study and assessment of a new technique

The aim of this work was to study the rapid fluid resuscitation technique in moderately and severely burned children; and to compare it with the conventional method. The present study was conducted on 40 burned children. Their age ranged from 3 months to 7 years and their BSA ranged from 15% to 28%. Half of them [20 children] were resuscitated using a rapid version of the modified Evans formula used in Alexandria Burns Unit. The other half [20 children] were given the same formula in an ordinary rate. Monitoring of the burned children was done using clinical and laboratory parameters. Statistical analysis of the results displayed significant changes in some parameters. Urine output increased in the rapid group. Improvement in the haematocrit values and normalization and stabilization of the heart rate were evident in the rapid group. The burned children in the rapid group received more fluid [2.9ml/% BSA/kg.] than in the conventional group [2ml/% BSA/kg]. Based on this study; fluid therapy in burned children should be given in an amount which is bigger and in a rate which is faster than in the ordinary formula. Recommendations regarding further studies and design of our own nomograms were made