Effect of different intrathecal morphine doses in low dilute dose bupivacaine for postoperative analgesia in anal surgery

Postoperative pain for anal surgery is a concern. Intrathecal morphine is effective and simple method for postoperative analgesia. The aim of this study is to compare the efficacy of 50 ug intrathecal morphine in low dilute bupivacaine 0.125% to 100 ug morphine in low dilute bupivacaine 0.125% and to compare the advantage and disadvantage in each group. Sixty patients of ASA grade I and II scheduled for anal surgery were randomly allocated to receive saddle block in setting position either lml of 0.25% hyperbaric bupivacaine with 1ml saline 0.9% [total volume 2ml to give concentration of 0.125%] [Group I n=20] or 1ml of hyperbaric bupivacaine 0.25% with 1ml of morphine 50 micro g [group II n=20] or 1ml hyperbaric bupivacaine 0.25% with 1ml of morphine 100 ug [group III n=20]. The duration of analgesia in the groups I, H, III were 2.8 +/- 0.55 hr, 6.4 +/- 0.8 hr and 11.2 +/- 1.2 hr respectively which was highly significant. Postoperative nausea and vomiting occurred at overall highly significant incidence during the first 24 hours, in group II, III, while there was no nausea and vomiting in group I. Urinary retention was also significant between group I, II and III with mean 3.95, 6.82 and 9.12 hours, in group II eight patients need catheter while in group Ill fourteen patients need catheter. As regard pruntus no patients in group I, while in group II one patients complaining of sever pruritus, in group Ill five patients complaining of sever pruritus and need treatment. A transient respirator depression with respiratory rate<8 pen minute and SPO2<90% occurred in one patients only in group III. No homodynamic changes

Effect of gender, birth weight and gestational age on serum 17-hydroxyprogesterone concentration and distribution among neonates in Saudi Arabia.

Blood samples from 813 newborns were spotted on to filter paper and the 17-hydroxyprogesterone concentration was measured using the Delfia (R) fluorometric immunoassay. The median, mean, and standard deviation (SD) for the total population were 20, 21 and (11) nmol/L respectively. Males had significantly higher levels than females with median, mean and (SD) of 22, 22 and (12) nmol/L. Similarly, low birth weight babies were found to have significantly higher levels than normal birth weight babies with median, mean and (SD) of 21, 24 (12) nmol/L. Preterm babies were also found to have significantly higher levels than full term babies, with median, mean and (SD) of 25, 29 (16) nmol/L. As experienced elsewhere, those factors should be taken into consideration when considering a cut-off point in any neonatal screening program for congenital adrenal hyperplasia.