Recovery profile for magnetic resonance imaging in pediatric day case- Sevoflurane vs. Isoflurane

Magnetic resonance imaging [MRI] is gaining ground over other investigations particular in study of brain and soft tissues. The MRI procedure is painless but requires an immobile patient for a successful study. Children are required to be sedated or anesthetized for this procedure. We compared two inhalational anesthetics, namely sevoflurane and isoflurane, for the recovery profile of each with aim to determine the ideal drug for early discharge of children. 100 patients aged 3 yrs to 10 yrs [ASA I and II] were divided into Group S [Sevoflurane], Group I [Isoflurane]. The induction time, duration of the MRI study, recovery and discharge times were recorded. The data were subjected to Students t-test and Levene's test for equal variance. In Group S, 27 male and 23 female were enrolled in comparison to 30 male and 20 female in Group I. The induction time in Group S resulted in a mean of 133.7 seconds [ +/- 19.32], Group I yielded a mean of 157.44 seconds [ +/- 24.20] p > 0.05]. The mean recovery time with Group S was 124.4 seconds [ +/- 31.57] when compared with Group 1 a mean of 376.46 seconds [ +/- 58.20] p < 0.05. The mean discharge time in Group S was 25.20 minutes [ +/- 5.71] in comparison to a mean of 37.40 minutes [ +/- 7.43] p < 0.05 in Group I. Sevoflurane can be an ideal inhalational anesthetic for Volatile Induction and Maintenance Anesthesia [V1MA] in children under going day case MRI examinations

Lactate and acid base changes during laparoscopic cholecystectomy

The observation of hemodynamic and metabolic impairment related to CO2 pneumoperitoneum and postoperative mesenteric ischemia reports following laparoscopic procedures have raised concern about local and systemic effects of increase intraabdominal pressure during laparoscopic procedures. The present study aims to evaluate the metabolic and acid base responses of using high pressure versus low pressure pneumoperitonium in patients undergoing laparoscopic cholecystectomy in a prospective randomized clinical trial. 20 ASA I-II patients scheduled for elective laparoscopic cholecystectomy were randomly allocated to one of two study groups; high pressure pneumoperitoneum 12-14mmHg [HPP, n=10] versus low pressure pneumoperitoneum 6-8mmHg [LPP, n=10] undergoing laparoscopic cholecystectomy. Arterial blood gases and lactate levels were determined after induction of anesthesia [before pneumoperitonium], then after 10 min, then 30 min after insufflations and at the end of surgery and 1 hour postoperatively. Nurses in recovery unit reported pain assessment starting postoperatively until 3 hours on a 10mm VAS [0-10]. Statistical significant was established at P<0.05. Bicarbonate was significantly [P>0.0412] lower in high pressure group at 30 min and 60 min after insufflations. In high pressure group lactate levels increased significantly as compared to low pressure group, [at 30 minutes after the establishment of abdominal pneumatic inflation P