Three minutes propofol after sevoflurane anesthesia to prevent emergence agitation following inguinal hernia repair in children: a randomized controlled trial / 대한마취과학회지

BACKGROUND@#Emergence agitation (EA) is a common problem after sevoflurane anesthesia among children. There have been mixed results with control of EA using propofol 1 mg/kg bolus following sevoflurane anesthesia. An infusion of 3 mg/kg of propofol over 3 min following sevoflurane anesthesia has been found to be promising in children undergoing magnetic resonance imaging scans. However, no studies have been conducted during surgical procedures. We aimed to examine the efficacy of transition to propofol for 3 min after cessation of sevoflurane anesthesia in children undergoing inguinal hernia repair.@*METHODS@#In this prospective randomized controlled trial, 64 children aged 1–12 years, scheduled for inguinal hernia repair, were randomized to receive either propofol 3 mg/kg over 3 min (propofol group) or no propofol (control group), after the cessation of sevoflurane anesthesia. EA was assessed using the Paediatric Emergence Anesthesia Delirium (PAED) scale and the Watcha scale. Emergence time and the duration of post-anesthesia care unit (PACU) stay were also recorded.@*RESULTS@#The incidence of ED was lower in the propofol group on both the PAED (81.3% vs. 15.6%, P < 0.001) and the Watcha (78.1% vs. 15.6%, P < 0.001) scales. The mean emergence time was 6.37 minutes longer in the propofol group with no significant difference in PACU times.@*CONCLUSIONS@#Transition to propofol 3 mg/kg over 3 min following sevoflurane anesthesia reduces the incidence of EA and improves the quality of emergence. Although emergence times were longer, the duration of stay in the PACU was similar with propofol use.

Three minutes propofol after sevoflurane anesthesia to prevent emergence agitation following inguinal hernia repair in children: a randomized controlled trial / 대한마취과학회지

BACKGROUND: Emergence agitation (EA) is a common problem after sevoflurane anesthesia among children. There have been mixed results with control of EA using propofol 1 mg/kg bolus following sevoflurane anesthesia. An infusion of 3 mg/kg of propofol over 3 min following sevoflurane anesthesia has been found to be promising in children undergoing magnetic resonance imaging scans. However, no studies have been conducted during surgical procedures. We aimed to examine the efficacy of transition to propofol for 3 min after cessation of sevoflurane anesthesia in children undergoing inguinal hernia repair. METHODS: In this prospective randomized controlled trial, 64 children aged 1–12 years, scheduled for inguinal hernia repair, were randomized to receive either propofol 3 mg/kg over 3 min (propofol group) or no propofol (control group), after the cessation of sevoflurane anesthesia. EA was assessed using the Paediatric Emergence Anesthesia Delirium (PAED) scale and the Watcha scale. Emergence time and the duration of post-anesthesia care unit (PACU) stay were also recorded. RESULTS: The incidence of ED was lower in the propofol group on both the PAED (81.3% vs. 15.6%, P < 0.001) and the Watcha (78.1% vs. 15.6%, P < 0.001) scales. The mean emergence time was 6.37 minutes longer in the propofol group with no significant difference in PACU times. CONCLUSIONS: Transition to propofol 3 mg/kg over 3 min following sevoflurane anesthesia reduces the incidence of EA and improves the quality of emergence. Although emergence times were longer, the duration of stay in the PACU was similar with propofol use.

Significance of maternal serum cytokines levels in preterm labor

The present study aimed to examine whether maternal serum cytokines levels are useful for the diagnosis of preterm delivery with histologic chorioamnionitis. The blood samples of 16 women who delivered preterm, between 29 and 35 weeks of gestation, were collected at delivery and the placentae were histopathologically examined for chorioamnionitis. The mean value of interleukin-6 [IL-6] was significantly higher in six women with histologic chorioamnionitis than that in ten women without histologic chorioamnionitis [mean 234.4 pg/ml, range 100-312 pg/ml, mean 62.4 pg/ml, range 5-15 pg/ml, respectively]. The IL-6 level was statistically correlated with the level of C-reactive protein [CRP] in preterm women. The levels of interleukin-8 [IL-8] did not differ between the two groups. The results suggested that the level of maternal serum interleukin-6 is more useful than other markers including CRP for the identification of women at risk of impending preterm labor with histologic chorioamnionitis

Effect of metformin treatment in ovulatory and pregnancy rates of patients suffering from polycystic ovarian syndrome [PCOS] with clomiphene citrate [CC] resistance

A double blind prospective study was planned to determine the effect of additional metformin treatment in. The ovulation and pregnancy rates among infertile anovular women who are suffering from polycystic ovarian syndrome [PCOS] and who are resistant to clomiphene citrate [CC] treatment alone. Prince Sultan military hospital, Taief, Saudi Arabia. This study included 25 infertile anovular patients with PCOS who were resistant to induction by CC. Participants received placebo or metformin, 500 mg three times daily, for 7 weeks. Information on reproductive steroids, gonadotropin, and oral glucose tolerance testing was obtained at baseline and after treatment. CC treatment was begun at 50 mg daily for 5 days. Serum Progesterone [P] level> 4mg/ml were considered to indicate ovulation in addition to ultrasound monitoring. With anovulation, the daily CC dose was increased by 50 mg for the next. Patients completed the study when they had six cycles, became pregnant, or experienced anovulation while receiving 150 mg of CC. In the metformin and placebo groups, 9 of 12 participants [75%] and 4 of 15 participants [27%] ovulated, and 6 of 11 participants [55%] and 1 of 14 participants [7%] conceived, respectively. Comparisons between the groups were significant. The use of metformin significantly increased the ovulation rate and pregnancy rate in anovulatory women. With PCOS who are resistant to CC

Prediction of placental inflammation In cases of preterm premature rupture of membranes: the role of antepartum fetal surveillance modalities

To assess the values of various modalities of fetal surveillance namely the nonstress test [NST]. modified fetal biophysical profile [FBP] and umbilical artery Doppler velocimetry study [S/D ratio] as predictors of placental inflammation in cases of preterm premature rupture of membranes [PROM]. Forty-three pregnant women with singleton fetuses between 27 and 34 weeks gestation and with preterm PROM were included in the study. AU cases were subjected to daily NST, modified FEP and umbilical artery S/D ratios till delivery was indicated for completion of 34 weeks, start of onset of labor or evidence of fetal compromise. After delivery, the placentas were send for histopathologic evaluation and were classified into two groups according to absence [group I] or presence [group II] of placental inflammation. The last NST, modified FBP and longitudinal trends of umbilical artery S/D ratios In the last 3 days before, delivery were correlated to placental histopathologic findings. There was no statistically significant difference between both groups regarding the incidence of reactive or non-reactive NST [P-NSL A statistically significant higher incidence of modified FBP