The Effect of Fentayl and Midazolam on the Incidence of Emergence Agitation in Children Following Sevoflurane Anesthesia for Tonsillectomy / 대한마취과학회지

BACKGROUND: It is well known that sevoflurane anesthesia is associated with emergence agitation (EA) in children, and that fentanyl may reduce its incidence. However, in case of midazolam, there have been conflicting reports. Therefore, we measured the effect of midazolam on EA after sevoflurane anesthesia and compared it with that of fentanyl. METHODS: Sixty pediatric patients receiving sevoflurane anesthesia for tonsillectomy was assigned to 3 groups. Saline 0.1 ml/kg (group P), midazolam 0.1 mg/kg (group M), or fentanyl 1 microgram/kg (group F) was administered intravenously 10 minutes before the end of surgery. The incidences of over-sedation (OS) and EA were checked three times at the postanesthesia care unit. RESULTS: Group M had a tendency to show a high incidence of OS, but its incidence of EA was not different from the other groups. In group F, OS and EA were less frequent than in groups P and M. CONCLUSIONS: After sevoflurane anesthesia for tonsillectomy, fentanyl effectively prevented EA, but midazolam elicited OS and was ineffective at preventing EA.

Prostaglandin F2alpha and Recurrences of Febrile Seizures / 대한소아신경학회지

PURPOSE: Intracerebroventricular injection of prostaglandin(PG) in the central nervous system is accompanied by a decrease in convulsions, a modulation of recurrences of seizures. Therefore, we observed the change of prostaglandin F2alpha(PGF2alpha) according to temperatures in the first febrile convulsions, and the relationship between the recurrence of febrile convulsions. METHODS: 93 patients with febrile convulsions recurrence could be studied for 42 months. All CSF samples were analyzed. During febrile convulsions, no anticonvulsant was used. We analyzed the recurrences of febrile convulsion according to PGF2alpha levels. RESULTS: The levels of PGF2alpha during 3 months recurrence group were 194.9+/-89.7 pg/mL, those during 4-6 months were 224.0+/-104.4 pg/mL, those during 7-9 months were 101.9+/-46.0 pg/mL, those during 10-12 months were 195.7+/-77.5 pg/mL, those during 13-18 months were 182.4+/-91.1 pg/mL, those during 19-24 months were 359.8+/-284.1 pg/mL, those during 25-36 months were 215.5+/-14.8 pg/mL and those during 37-42 months were 191.5+/-5.0 pg/mL. CONCLUSION: Elevated concentrations of PGF2alpha in febrile convulsions were found and not related to the increasing rate of fever. In the recurrent groups of febrile convulsions, there was no relationship between PGF2alpha levels and recurrences time of febrile convulsions except 7-9 months recurrence group. Although the exact mechanism of recurrence of febrile convulsion is unclear, we think that more consistent study of this recurrence is important to clarify the role of prostaglandin in the first febrile convulsion and the relationship to recurrences of febrile convulsions.

The Variations of CSF Glucose-To-Blood Glucose Ratio accoring to the Time of Blood Sampling in Aseptic Meningitis

The Measurement of CSF glucose and CSF glucose-to-blood glucose ratio is a very useful laboratory test for the differential diagnosis of meningitis. We have observed the change of blood glucose & CSF glucose-to-blood glucose ratio according to the time of blood sampling in 84 patients with aseptic meningitis who had been admitted to the department of pediatrics, Dong Kang hospital from May 1993 to June 1993. The results obtained were as follows: 1) The blood glucose level examined with blood sample drawn just before lumbar puncture and one just after lumbar puncture was 98.29+/-16.20mg/dl and 106.49+/-19.47mg/dl, respectively. 2) The blood glucose level examined with blood sample drawn just before lumbar puncture and one 30 min. after lumbar puncture was 96.47+/-21.52mg/dl and 117.00+/-22.12mg/dl, respectively. 3) The CSF glucose-to-blood glucose ratios examined with blood sample drawn just before lumbar puncture and one just after lumbar puncture was 67.70+/-12.40% and 62.83+/-12.62%, respectively. 4) The CSF glucose-to-blood glucose ratios examined with blood sample drawn just before lumbar puncture and one just after lumbar puncture was 70.10+/-21.77% and 56.35+/-13.75%, reskpectively. We concluded that a simultaneous blood glucose level should be taken just before lumbar puncture.