[Postoperative pain management with caudal blockage versus apotel[registered] administration in pediatrics undergoing inguinal herniorrhaphy under sevoflurane anaesthesia]

Postoperative pain is a frequent complication in young children undergoing general anaesthesi. Sevoflurane anaesthesia in children has been related with higher incidence of postoperative emergence delirium in comparison with halothane, which some blame the pain as it's main reason. The current study was designed to compare the effect of caudal block versus Apotel adminstraion on postoperative pain in pediatrics undergoing inguinal herniorrhaphy under sevoflurane anaesthesia. In this clinical trial, 60 children aged 2-8 years who were candidate for elective inguinal herniorrhaphy were included. After maintenance with sevoflurane, the patients were randomly allocated to receive caudal anesthesia or intravenous Apotel 15 mg.kg-1. After extubation, patient's pain scores were assessed with Children's Hospital of Eastern Ontario Scale [CHEOPS]. Fentanyl was administered in cases suffered from acute pain with CHEOPS >/= 10. Postoperative pain in caudal block group was significantly lower than in Apotel group [CHEOPS=7.2 vs 8, p=0.017] and opioid was administered much more in Apotel group [p=0.003]. Caudal block in comparison with Apotel is more effective in postoperative pain reduction and is associated with less need for opioids

Comparing the efficacy of prophylactic P6 acupressure, ondansetron, metoclopramide and placebo in the prevention of vomiting and nausea after strabismus surgery

To compare the efficacy of acupressure wrist bands, ondansetron, metoclopramide and placebo in the prevention of vomiting and nausea after strabismus surgery. Two hundred patients, ASA physical status I or II, aged between 10 and 60 years, undergoing strabismus surgery in Farabi Hospital in 2007-2008 years, were included in this randomized, prospective, double-blind and placebo-controlled study. Group I was the Control, group II received metoclopramide 0.2 mg/kg, group III received ondansetron 0.15 mg/kg iv just before induction, in Group IV acupressure wristbands were applied at the P6 points. Acupressure wrist bands were placed inappropriately in Groups I, II and III. The acupressure wrist bands were applied 30 min prior to the induction of anesthesia and removed six hours after surgery. Postoperative nausea and vomiting [PONV] was evaluated within 0-2 hours and 2-24 hours after surgery by a blinded observer. Results were analyzed by chi-square test. A P value of < 0.05 was taken as significant. The incidence of PONV was not significantly different in acupressure, metoclopramide and ondansetron during the 24 hours. Acupressure at P6 causes a significant reduction in the incidence of PONV 24 hours after strabismus surgery as well as metoclopramide 0.2 mg/kg and ondansetron 0.15 mg/kg iv for patients aged 10 or more