Comparison of Pain Control Method and Assessment on Postoperative Pain in Pediatric Urological Surgery of Penoscrotal and Inguinal Regions / 대한비뇨기과학회지

PURPOSE: This study was designed to evaluate the effects of caudal block or/and local infiltration on postoperative pain control in pediatric patients, and whether the faces pain rating scale (FPS), visual analogue scale (VAS) or sleep disturbance scale (SDS) values were estimator dependent (parents, doctors and nurses). MATERIALS AND METHODS: Thirty four children (average age 2.8+/-2.4 years), undergoing inguinal and scrotal surgery, were randomly allocated to one of three groups; combined caudal block with local infiltration (group I), caudal block only (group II) and neither of the above two (group III). Parents, doctors and nurses assessed the FPS, VAS and SDS before and after surgery, and the side effects were assessed after surgery. RESULTS: The mean SDS, FPS and VAS values in Group III were significantly higher than those in groups I and II at 1 and 3 hours postoperatively. All patients slept with a discontented look 1 hour postoperatively, but gradually improved and normalized 12 hours postoperatively. The mean FPS and VAS values were highest 1 hour postoperatively, and decreased with time in all groups. The mean pain value, as assessed by parents, tended to be higher than those assessed by healthcare professionals - doctors and nurses, but the correlation between the parents and healthcare professionals for the SDS, FPS and VAS assessments was statistically significant (intraclass correlation coefficients; 0.64, p<0.05). There were no side effects in any patient. CONCLISIONS: This study suggests that caudal block with local infiltration may be more useful for postoperative pain control, and all three pain scales are useful for assessing the postoperative pain associated with pediatric urological surgery of the penoscrotal and inguinal regions.

Prolaction May not Stimulate Generation of New Cells after Transient Focal Cerebral Ischemia in Adult Male Rat Brain: a Preliminary Study

BACKGROUND: Production of neuronal progenitors is usually stimulated in the forebrain subventricular zone of mice after the intracerebroventricular infusion of prolactin. As a preliminary study, we infused prolactin to the male rat brain to test the hypothesis that prolactin promotes new cell proliferation in the brain and functional recovery after focal ischemia. METHODS: Male rats were subjected to intraluminal middle cerebral artery occlusion. Prolactin was administered to the surface of the brain for 5 or 14 days starting 24 or 48 hours after stroke onset at doses of 6.4 microgram per day. We administered the same volume of saline to the other ischemic rats used as a control group. Some rats were killed 6 or 17 days after stroke for analysis of infarct volume and newly generated cells within the subventricular zone and the striatum. The other rats were tested for neurological recovery 24 days after stroke. RESULTS: There was no significant difference of infarct volume among the experiment groups. Treatment with prolactin did not increase the numbers of bromodeoxyuridine-immunoreactive cells in the subventricular zone and the striatum. Treatment with prolactin did not enhance neurological recovery in all tests performed. CONCLUSIONS: In this preliminary study, prolactin did not enhance new cell generation in the male rat brain nor reduce the neurological deficits after ischemic stroke.