The effects of maternal presence during anesthesia induction on salivary cortisol levels in children undergoing tonsillectomy and/or adenoidectomy.

OBJECTIVE: Although parental presence during anesthesia induction is suggested to diminish operative stress level in children, there have been conflicting results about this strategy. The aim of this study was to evaluate the effects of maternal presence during induction on operative stress level in children who had tonsillectomy and/or adenoidectomy by determining the salivary cortisol levels. DESIGN: Non-randomized clinical study. SETTING: Preoperative and postoperative recovery rooms, operating room. PATIENTS: The study included 48 children between the ages of 5-12years who underwent tonsillectomy and/or adenoidectomy. INTERVENTIONS: The patients were divided into 2 groups. The children in group 1 were separated from their mothers at the preparation room. The children in group 2 stayed together with their mothers till the anesthesia induction. MEASUREMENTS: State Trait Anxiety Inventory (STAI) was performed to the mothers and children preoperatively. Salivary cortisol levels were evaluated in 4 different time frames: 1) in preparation room, 2) after anesthesia induction, 3) at the 30th minute of operation, and 4) in postoperative recovery room. MAIN RESULTS: There were no statistically significant differences between groups regarding demographic features, and operation or anesthesia times. The child's or mothers' preoperative anxiety scores were not different between the groups. Salivary cortisol levels in group 1 were significantly increased after induction and in recovery room compared to those in group 2 (p: 0.001, and p: 0.02, respectively). CONCLUSIONS: We have determined decreased salivary cortisol levels during anesthesia induction and recovery in the maternal presence revealing diminished stress in these periods. Further studies are warranted to determine the effects of parental presence during anesthesia induction especially on surgical outcomes.

Detection of 1311 polymorphism in the glucose-6-phosphate dehydrogenase gene by microarray technique.

INTRODUCTION: Nucleotide 1311 polymorphism at exon 11 of the glucose-6-phosphate dehydrogenase (G6PD) gene is fairly common in various populations worldwide, especially among Mediterranean populations. In this study, 1311 polymorphism in G6PD-deficient cases was identified by microarray technique. MATERIAL AND METHODS: Four hundred and fifty clinically healthy subjects were screened and 32 cases were found to have G6PD deficiency (7.11%). Our analysis of genomic DNA samples from 32 G6PD-deficient individuals revealed that the number and percentage of subjects who had a C-to-T alteration at nucleotide 1311 were 21 and 4.7% respectively. Given that the frequency of 1311 polymorphism has been reported in previous studies to be fairly high among G6PD-deficient people with the Mediterranean mutation, our data seem to be inconsistent with what we would expect for this particular region. RESULTS: The highly diverse ethnic background of the Adana population which probably results from the high level of immigration into this part of Turkey may be one of the most sensible explanations for this unexpected finding. Nevertheless, it seems that our results need to be confirmed in larger studies. CONCLUSIONS: The polymorphism studies in the G6PD gene may help us to illuminate the genetic basis of the G6PD deficiency in different regions and in various ethnic groups, and also to discover the influence of a specific polymorphism on the clinical course of the deficiency.