RESUMEN
Objective: Caudal block has gained much popularity in the past few decades to provide analgesia in pediatric population. Although local anesthetic agents remain the mainstay for caudal blocks, addition of additives to the solution improves quality and duration of analgesia and reduces the toxicity by allowing lower concentrations of the local anesthetic agents. In this regard opioids have been studied extensively, but there is not much comparative research about caudal clonidine. The aim of our current study was to compare the caudal block characteristics of ropivacaine 0.25% with clonidine 1 microg/ kg versus ropivacaine 0.25% with fentanyl lug/kg in pediatric patients
Methodology: A total of 60 ASA 1 children of either gender, age from 2 to 10 years, weighing 10 to 30 kg, scheduled for lower abdominal or limb surgery, were enrolled for this study Children were randomly allocated into 2 equal groups. Group RF received 1 ml/kg of ropivacaine 0.25% plus fentanyl 1 pig/kg via caudal route. Group RC received 1 ml/ kg of ropivacaine 0.25% plus clonidine 1 microg/kg via same route. All children were administered general anesthesia followed by caudal block for postoperative analgesia. Duration of analgesia, sedation score and any side effects were noted. Calculation of sample size was done by using power analysis. The non-parametric data comparison was done by Student's t-test
Results: Duration of analgesia was significantly prolonged in RC group. Dose requirement for rescue analgesia was significantly lesser in group RC. There was no significant difference between both groups for hemodynamic response after caudal block. The incidence of side effects were not significant
Conclusion: In conclusion clonidine and fentanyl, both improve the quality of analgesia when used with ropivacaine in caudal block in pediatric patients, but the quality of analgesia and duration with clonidine plus ropivacaine is superior to fentanyl plus ropivacaine
RESUMEN
Lingual thyroid [LT] gland is a rare clinical entity which occurs due to failure of thyroid gland to descend to its normal cervical location during embryogenesis. Maternal antithyroid immunoglobulins may impair gland descent during early fetal life and cause lingual thyroid. This condition is associated with increase in levels of thyroid stimulating harmone [TSH]. As the ectopic thyroid grows, requirement of thyroid harmone increases thus many patients with ectopic thyroid are associated with hypothyroid and require treatment
Ectopic thyroid gland is located at base of tongue and can present with dysphagia, dysphonia, upper airway obstruction and hemorrhage
Oropharyngeal mass can lead to difficult intubation and failure of ventilation. Evaluation of airway and indirect laryngoscopy may hint towards need of fiberoptic intubation. We present a case of 11 years old child of LT for appendectomy under general anesthesia
RESUMEN
Treacher Collins Syndrome [TCS] is an autosomal dominant disorder of craniofacial development. It is characterized by bilateral and symmetric abnormalities of the structures derived from the first and second branchial arch region. The patients with TCS can have difficult intubation because of retrognathia and severe facial deformity. Here we report a case of 11 months old boy with TCS with anticipated difficult airway posted for cheiloplasty under general anesthesia which was successfully managed
RESUMEN
This study was done to compare effects of intranasal midazolam and intranasal midazolam with ketamine for premedication of children aged 1-12 yrs undergoing intermediate and major surgeries. Midazolam and Ketamine have already been used as premedicants in children. Our aim was to find out advantage of combination of midazolam with ketamine over midazolam by nasal route. Sixty children of age group 1-12 yrs of American Society of Anesthesiologists [ASA] grade 1 and 2 were selected. Group A- midazolam [0.2 mg/kg], Group B- midazolam [0.15 mg/kg + ketamine 1 mg/kg]. Both groups received drug intranasally 30 min before surgery in recovery room with monitored anesthesia care. Onset of sedation, sedation score, emotional reaction, intravenous cannula acceptance, and mask acceptance were studied. Unpaired t test and chi square test. Sedation score, anxiolysis, attitude, reaction to intravenous cannulation, face mask acceptance, and emotional reaction were significantly better in midazolam with ketamine group. Intra operatively, in both groups, pulse rate, oxygen saturation, and respiratory rate had no significant difference; also, post operatively, no significant difference was observed in above parameters, post operative analgesia was significantly better in midazolam with ketamine group. Intra nasal premedication allows rapid and predictable sedation in children. Midazolam as well as combination of Midazolam with ketamine gives good level of sedation and comfort. But quality of sedation, analgesia, and comfort is significantly better in midazolam with ketamine group. No significant side effects were observed in both groups