The safety of propofol infusion as an adjunct to regional anesthesia in children less than three years old

Background: Propofol, a sedative agent with quick onset and short duration of action, has long been used for many adult procedures requiring anesthesia and sedation. There is hesitance, however, to its use for children because of several reports of adverse events. This hesitance reflects more of a scarcity of pediatric clinical trials rather than a proven clinical problem. This study is therefore undertaken to determine the safety of propofol infusion in normal healthy children less than three years old who will undergo elective surgeries. Methods: This was a prospective study of 24 ASA I patients under 3 years of age who underwent either lower abdominal or lower extremity surgery under combined general and regional anesthesia, and cheiloplasty/palatoplasty under general anesthesia with infraorbital block. Patients were put to sleep by sevoflurane gas induction. Endotracheal intubation was facilitated by atracurium. Blood samples for arterial blood gases (ABGs), creatinine, alanine aminotransferase (ALT) and triglycerides were extracted. After the regional block was established, sevoflurane was discontinued and the propofol infusion was started. The range of vital signs, total dose of propofol and the total time it was administered were noted. After 24 hours, ABGs, creatinine, triglycerides and ALT levels were determined. Results: Pearsons Correlation test showed that no linear relationship exist between the dose of propofol and the postoperative levels of triglycerides, creatinine and ALT. Preoperative ABG analysis showed that 29 percent had metabolic acidosis, 33 percent had respiratory acidosis and 21 percent had normal values. Postoperatively, 75 percent had normal ABG results while 25 percent had metabolic acidosis. Conclusion: Propofol is safe for use in children less than 3 years of age. No significant elevations in the postoperative levels of creatinine, ALT and triglycerides were noted in the study. Majority of patients had normal ABG results postoperatively. (Author)

How well do the in-service examination scores correlate with performance in the written diplomate certification examinations?

Objectives: This study aims to answer the question:How well do the In- Service Examinations predict performance int he Written Diplomate Certification Examination? Methodology: Descriptive statistics and measures of central tendencies were used to described the distribution of the data. Linear regression using the Pearson Product Moment Correlation was used to evaluate data. Results: Of the 50 residents who were in the program from 1999 to 2000, only were included in the study. One did not take the In- Service Examination during his 2nd year of residency while the other has yet to take her WDCE. Conclusion: This study found a high positive correlation of scores in the Philippine Board of Anesthesiology ISEs and the WDCE. The In- Service Examination is a useful tool for gauging the readiness of a resident to perform well in the Written Diplomate Certification Examination. It is also a useful method for assessing the rate of improvement of the anesthesiology resident during his training. The results of this study help to established the ISEs as a mean of determining the strengths and weaknesses of anesthesia trainees and their training programs.