ABSTRACT
Objective: Postanesthetic emergence agitation is a common problem in pediatric postanesthetic care unit with an incidence ranging from 10 to 80%. This study was done to determine the prevalence of emergence agitation and associated risk factors in pediatric patients who underwent general anesthesia
Methods: This cross-sectional descriptive and analytic study was performed on 747 pediatric patients aged 3- 7 years that underwent general anesthesia for various elective surgeries at Bou-Ali Sina Hospital in Sari, Iran between January 2010 and January 2011. A non-probability quota sampling technique was used. The presence of emergence agitation was recorded using Pediatric Anesthesia Emergence Delirium Scale. The factors linked with Emergence Agitation were recorded in a questionnaire. The data were analyzed using SPSS software 16 and independent sample t-test, chi[2] and binary logistic regression. P-values less than 0.05 were considered as significant
Findings: One hundred thirty-four [17.9%] children had emergence agitation. The most frequent surgical procedures were ENT surgical procedures 315 [42.2%], abdominal surgery 177 [23.7%], orthopedic surgery 137 [18.3%], urology 97 [13%] and ophthalmic surgery 24 [3.2%]. Otorhinolaryngological surgical procedures [P=0.001], pain [P<0.05] and induction behavior of children [P<0.005] were associated with higher rates of post anesthetic emergence agitation [P=0.001]
Conclusion: This study identified the multiple independent risk factors which are associated with emergence agitation in children. To minimize the incidence of postanesthetic emergence agitation, these risk factors should be considered in the routine care by care providers in postanesthetic care unit
ABSTRACT
Congenital midline cervical cleft [CMCC] is a rare developmental anomaly of the anterior neck, mostly found in Caucasian females. Most authors consider it within the spectrum of branchial arch developmental abnormalities. There have been about 100 reported cases in the literature. However, there is no agreement on the age of surgery in this anomaly. In this report we present our experience of managing this anomaly in the early neonatal period in two neonates. One of them had concomitantly congenital heart disease. It is important to recognize this rare congenital anomaly in neonate. Although the exact time of surgery for CMCC is not mentioned, based on our results the earliest time of intervention is recommended since then the operating result will be excellent
ABSTRACT
We report a case of severe tissue ischemia after umbilical catheterization in a preterm newborn. Umbilical catheters can accidentally enter branches of the iliac artery during attempted placement in the umbilical vein. If these misplacements are not recognized by radiology and promptly corrected, arterial obstruction may lead to ischemia and infarction of the extremities. This is the first report of below-knee gangrene due to peripheral vasospasm or thrombosis occurring after umbilical vein catheterization [UVC]. We discuss that the radiographic verification is essential before infusing medications
Subject(s)
Humans , Infant , Female , Catheterization/adverse effects , Lower Extremity/pathology , Umbilical VeinsABSTRACT
Jejuno-ileal atresia [JIA] is a congenital anomaly characterized clinically by bilious vomiting and abdominal distension. The incidence of JIA is between 1: 330 to 1: 3000 live births in different parts of the world. It has been associated with various congenital anomalies but the association of JIA with biliary atresia is extremely rare [0-3.2%]. We herein present a case of jejunal atresia with meconium peritonitis associated with biliary atresia. The patient was a boy who was born at 39 weeks of gestation with polyhydramnious detected on Prenatal Ultra Sonography done at 8th month of gestation. It is important to explore gallbladder in cases of JIA especially when associated with meconium peritonitis