Effectiveness of oxygenation under the drape in phacoemulsification with intraocular lens implantation: a randomized clinical trial.

OBJECTIVE: To compare the oxygen saturation and comfort of the patients undergoing phacoemulsification with intraocular lens implantation (PE/IOL) between the patients with and without oxygenation under the linen drape. SETTING: Institutional practice. MATERIAL AND METHOD: A randomized, triple-blind, clinical equivalence trial was conducted. Eighty consecutive patients, scheduled for PE/IOL under topical or subconjunctival anesthesia, were randomized The patients in group 1 received 5 liters/minute flow of 100% oxygen via tubes attached to the upper chest walls. Sham oxygenation was given to the patients in group 2. Patients, surgeons and investigators were masked. The oxygen saturation was recorded every 10 minutes. The patients rated the comfort score within 15 minutes after operation. RESULTS: In group 1 (n = 37), mean age was 68.2 +/- 10.5 years and mean operative time was 29.4 +/- 7.2 minutes. In group 2 (n = 43), mean age was 66.9 +/- 10.6 years and mean operative time was 27.2 +/- 6.3 minutes. In both groups, the oxygen saturation ranged from the mean of 97.3 to 100% throughout the present study. The 99% confidence intervals of the mean differences of the oxygen saturation at 10, 20, and 30 minutes after draping were -1.60 to 0. 17%, -1.63 to 0.05%, and -2.37 to 0.74%, respectively. The comfort score was 84.9% in group 1 and 89.8% in group 2 (p = 0.61). CONCLUSION: With or without oxygen flow under the drape with the tip of the oxygen tube 1.5 cm away from the chin during PE/IOL, the patients' oxygen saturation is equivalent. The patients' comfort is not statistically different. Oxygenation under the linen drape seems to be unnecessary in uncomplicated cases.

Pain-relieving effect of local steroid injection in uvulopalatopharyngoplasty.

An analytical prospective study was performed to determine the post-operative pain-relieving effect of local steroid suspension injection in uvulopalatopharyngoplasty. From February 2000 to October 2000, 48 adult patients from 20 to 67 years of age, were scheduled to receive uvulopalatopharyngoplasty. Triamcinolone acetonide (Kenacort A) was injected onto the raw surface of the left-sided tonsillar fossa and left-sided soft palate after tonsillectomy and uvulopalatopharyngoplasty. Other preoperative and post-operative medications including antibiotics, anesthesia and surgical techniques were standardized. Visual analog scales were used to assess the level of pain sensation on the left and right side of the throat daily from day 0 (Operative day) to post-operative day 10. A paired t-test showed significant differences in post-operative pain level between the study side (left) and the control side (right) at day 2, day 4, and in the overall analysis (p < 0.05).

Ice test for ocular myasthenia gravis.

A prospective, non randomized comparative study was conducted to examine the efficacy of the ice test in differentiating myasthenia gravis (MG) ptosis from non MG. Twenty patients with MG ptosis and 20 with non MG ptosis were evaluated by measuring the palpebral fissures pre and post ice test applied on the eyelids for 2 minutes. The difference in widening of palpebral fissure 2 mm or more was considered as a positive ice test. The results showed that 19 from 20 MG patients had positive ice test, whereas, all non MG patients had negative results. The sensitivity and specificity of the test were 95.0 per cent and 100 per cent, respectively while the accuracy or efficacy of the test was 97.5 per cent. In conclusion, the ice test is a useful, simple, safe, fast, cheap, and easy to perform for the screening and diagnosis MG patients with ocular ptosis.

Homograft myringoplasty-controlled button technique: a preliminary report.

The successful outcome of homograft myringoplasty in small and medium perforation of the tympanic membrane was only 44.12 per cent. A better result was obtained in the small perforations (59.10%) compared with the medium ones (16.77%). We conclude that the procedure should be appropriate for repairing the incomplete healing of the tympanic membrane following standard tympanoplasty and removal of the tympanostomy tube. Furthermore this procedure is simple, safe, cost-effective and can be done in the out-patient department.