Comparison of nasal Midazolam with Ketamine versus nasal Midazolam as a premedication in children

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

Efficacy of topical nasal steroids and total inferior turbinectomy in hypertrophic rhinitis

To compare the efficacy of topical nasal steroids therapy with total inferior turbinectomy in relieving nasal obstruction caused by inferior turbinate hypertrophy. Randomized Controlled Trials [RCT]. The study was conducted in the ENT department, Combined Military Hospital Rawalpindi from October 2006 to July 2007. Sixty patients suffering from allergic rhinitis were divided in Two groups of thirty partients. Group A underwent total inferior turbinectomy where as Group B advised Betamethasone nasal drops for two months. Relief in terms of nasal obstruction was assessed on Visual analogue scale two months after commencement of treatment. Chi-square test was applied as test of statistical significance to compare the two groups. Total inferior turbinectomy was found to be clinically superior to topical betamethasone drops in relieving nasal obstruction caused by inferior turbinate hypertrophy [p<0.001]. Total inferior turbinectomy is a better method of relieving obstruction as compared to topical betamethasone drops in nasal obstruction due to hypertrophied inferior turbinates

Acción del Etanol sobre el Epitelio Nasal y Glándulas Septales de Ratas, Durante la Lactancia / Action of Ethanol on Rat Pups Nasal Epithelium and Septal Glands, During Lactation

El consumo materno de etanol durante la lactancia altera la composición de la leche, provoca la aparición de etanol y acetaldehído en la leche y agrava los efectos del etanol en las crías de ratas. De este modo, fueron estudiados los efectos del etanol, administrado a las ratas madres durante la lactancia, sobre el epitelio respiratorio y en las glándulas septales anterior y posterior de las crías lactantes con 21 días de vida postnatal. Las ratas recibieron etanol al 20% en el bebedero, ad libitum durante los 21 días que amamantaron. Los controles recibieron un volumen similar de agua sin alcohol. Las crías fueron sacrificadas en el 21 día. Las cabezas fueran cortadas frontalmente. Los cortes seriados de 6 µm de grosor fueron teñidos con hematoxilina y eosina. Fueron determinados los parámetros nucleares de los epitelios respiratorio y glandular, así como los volúmenes citoplasmático y celular, relación núcleo-citoplasma, densidades numérica y superficial y espesor del epitelio. El peso corporal medio de las crías control fue 34,9 g y en las tratadas 20,2 g. Histologicamente, el epitelio respiratorio se mostró adelgazado en el grupo tratado, constituido por células abundantes y menores, con núcleos menores. La glándula septal posterior presentó ácinos menores. En este trabajo, el etanol indujo un cuadro de hipotrofia epitelial (respiratorio y glandular), indicando una acción directa sobre las células de la mucosa nasal, además de retardar el desarrollo de las crías intoxicadas.

Maternal ingestion of ethanol during lactation alters the chemical composition of milk, results in the appearance of ethanol and acetaldehyde in milk, and exacerbates the effects of ethanol on the rat pups. So that, the effect on respiratory epithelium and anterior and posterior septal glands in 21-day-old suckling pups of ethanol treated mothers was studied. Female rats received dinking water ad libitum containing ethanol (20%) throughout the whole lactation. Control animals received a similar volume of water without ethanol. Lactent rats (21 day-old) were killed by lethal dose of anesthetic. The heads were serially sectioned (6µm thick) in a frontal plain, and stained with haematoxylin and eosin. Cell nuclear parameters were estimated, as well as cytoplasm and cell volume, nucleus-cytoplasm ratio, number and surface densities, and epithelial thickness. Mean body weight of the pups was 34.9 g for the controls and 20.2 g for the treated group. Histologically, the respiratory epithelium was thinner, with more numerous and smaller cells and small nuclei. The posterior septal glands showed smaller acini. In this paper, ethanol induced epithelial (respiratory and glandular) hypotrophy, indicating a direct action in nasal mucous cells, besides retarded development in pups.

Infiltraçäo anestésica da fossa ptérigo-maxilar e do nervo nasociliar: aspectos anátomo-fisiológicos / Anesthetic infiltration of the pterigum-maxilla fossa and nasociliar nerve: anatomo-physiological aspects

Säo discutidos os aspectos anatômicos da fossa ptérigo-maxilar e do nervo nasociliar, cujas infiltraçöes anestésicas säo atos simples, rápidos, eficazes e seguros em vários procedimentos odontológicos e otorrinolaringológicos, possibilitando a realizaçäo de cirurgias nasossinusais bem menos sangrantes com a utilizaçäo de doses bem menores de anestésicos gerais, em virtude da aboliçäo dos estímulos álgicos e consequente näo liberaçäo de catecolaminas