Exposure of neonatal mice to Sevoflurane may induce male germ cell apoptosis in testicular tissue after puberty

Background: common use of sevoflurane in congenital defects during repeated surgeries may have detrimental effects on spermatogenesis after puberty

Objective: this study investigated sevoflurane effects on spermatogenesis process in male mature mice after exposure in prepubertal time

Materials and Methods: 24 neonatal NMRI male mice were randomly classified in three groups. Experimental 1 and 2 groups [exposure to 1 minimum alveolar concentration [MAC] and 2 MAC sevoflurane, respectively in 2 lit/min oxygen [O[2]] for 7 days [30 min, daily] and control. All groups were sacrificed after 2 months. Histological assessment, immunohistochemistry and apoptosis process was done. Bax and Bcl2 expression was evaluated in the testicular tissue by real time Poly Chain Reaction

Results: our results showed that the integrity of testicular tissue was preserved in both experimental groups. Count of spermatogonial cells had significant decrease in group 2 compared to others. The rate of apoptosis in spermatogonial cells was 15+/-3% and 9+/-2% in the group 2 and 1, respectively. Also, Bax/Bcl[2] ratio was 0.2615, 1.0070 and 9.3657 in control, experimental group 1 and 2, respectively. This result was significant [p

Conclusion: continuous exposure of 2 MAC sevoflurane in 2 lit/min O[2] simultaneous during prepubertal may create more testicular tissue damage in terms of cellular and molecular function compared to continuous exposure to lower level of sevoflurane by increase in ratio of Bax/Bcl[2] and apoptosis in germ cells after puberty

[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

Ondansetron pretreatment reduces pain on injection of Propofol

To assess the effectiveness of ondansetron pretreatment in alleviating propofol injection pain, 135 patients were randomly assigned to one of following three groups. Group 1 who received up to 2 mL pretreatment 50 mg tramadol in the saline, group 2 cases who received up to 2 mL pretreatment 4 mg ondansetron in saline, and group 3 who received up to 2 mL solution saline. A 20 gauge cannula was placed into the largest vein on the dorsum of the hand. Tourniquet was closed to the arm above the cannula and inflates to 70 mmHg, and then drug was injected. After 20 seconds, the tourniquet deflated, and propofol 2mg/kg injected over 10 seconds and pain assessment was made. Tramadol and ondansetron significantly reduced the incidence and severity of propofol injection pain more than placebo [P=0.001]. The efficacy of ondansetron in alleviating the pain on injection of propofol was no different from tramadol [P=0.330]. Ondansetron pretreatment may be used to reduce the incidence of pain on injection of propofol, an advantage added to the useful prevention of postoperative nausea and vomiting

[Systemic side-effects of topical ophthalmic drops in a 17-year old boy candidate for deep viterectomy: a case report]

Drugs applied topically to the eye may be absorbed systemically to a substantial degree, with the potential to cause serious systemic side-effects. Children may be particularly vulnerable to systemic effects of topically applied agents as topical doses are often not weight-adjusted. This article describes a case of serious systemic side-effect by the use of topical phenylephrine, tetracaine, tropicamide and atropine in a 17-year old boy candidate for deep viterectomy in Farabi Hospital in 1389. Following application of the aforesaid eye drops, the patient developed hypertension and subsequent loss of conciseness. Several types of eye drops and their repeated use can lead to their systemic absorption and medical complications due to overdose. Strategies to minimize systemic absorption should be applied, including use of low concentrations of ophthalmic drugs, administration of one type of the drug, use of microdrops and punctal occlusion to minimize absorption via the nasolacrimal duct. While administering ophthalmic drops, one should take these precautions to minimize the systemic effects of the drugs to prevent subsequent complications