Beneficial effects of the combined techniques of caudal and general anesthesia in the pediatric patient: two case reports.

The practice of combining a caudal anesthetic with a general anesthetic is frequently used in the management of pediatric patients. The principal advantage is improved postoperative pain management. Additionally, the perioperative reduction of inhalation agents as well as narcotic and non-narcotic analgesics provides a faster, more pleasant recovery from anesthesia that may result in a shorter hospital stay. The addition of caudally administered narcotics provides superior postoperative pain management in the pediatric patient requiring prolonged hospitalization. This article examines this combined technique in two pediatric patients: one, an ambulatory patient, the second, a patient requiring a postoperative intensive care admission.

Wound repair and the potential use of growth factors.

Failure of wounds to heal increases the physical and financial burden of hospitalization and increases the work load for health care professionals. Although careful attention to nutrition (including adequate replacement of vitamins and trace mineral elements), tissue perfusion and oxygenation, and wound dressing and sanitation promote more rapid and complete healing, some wounds respond only slowly or not at all to these conventional treatment modalities. A group of polypeptide growth factors, including epidermal growth factor, platelet-derived growth factor, transforming growth factor beta, and basic fibroblast growth factor, have been found to promote or hasten healing in animal models. This technology is now moving into the clinical arena where its potential for human healing must be evaluated.