Short-Term Changes in Postoperative Cognitive Function in Children Aged 5 to 12 Years Undergoing General Anesthesia: A Cohort Study.

Due to the neurotoxicity effects of general anesthesia (GA) and sedatives found in animal studies, there is a general recommendation to avoid nonurgent surgical procedures requiring anesthesia in children younger than 3 years of age. The aim of this study was to determine the incidence of anesthesia-related postoperative cognitive dysfunction (POCD) on the first day (Day 1) and at 6 weeks after elective noncardiac surgery in school-age children.This was a prospective cohort study of 118 children undergoing GA and 126 age-matched controls of school children aged 5 to 12 years.

Using illness scripts to teach clinical reasoning skills to medical students.

Background And Objectives: Most medical students learn clinical reasoning skills informally during clinical rotations that have varying quality of supervision. We conducted a randomized controlled trial to determine if a workshop that uses "illness scripts" could improve students' clinical reasoning skills when making diagnoses of patients portrayed in written scenarios.

Methods: In 2007--2008, 53 fourth-year medical students were randomly assigned to either a family medicine (intervention) or psychiatry (control) clerkship at The Chinese University of Hong Kong.

Incidence and risk of adverse perioperative events among surgical patients taking traditional Chinese herbal medicines.

Background: The use of traditional Chinese herbal medicines (TCHMs) among the presurgical population is widespread, but their impact on perioperative patient care is unclear. The authors estimated the incidence and risk of TCHM-related perioperative events.

Methods: In a Hong Kong cohort study, 601 patients undergoing major elective surgery were asked about their Western medicine and TCHM use in the 2 weeks before surgery.

Possible interaction between sevoflurane and Aloe vera.

Objective: To describe a patient with massive intraoperative bleeding after oral consumption of Aloe vera tablets.

Case Summary: A 35-year-old woman lost 5 L of blood during surgery as a result of a possible herb-drug interaction between Aloe vera and sevoflurane.

Discussion: Aloe vera is a common herb used for antiinflammatory and antiarthritic activity, as well as antibacterial, hypoglycemic, and lipid-lowering effects.

Comparison of rocuronium and suxamethonium for rapid tracheal intubation in children.

Background: The purpose of our study was to determine whether a smaller dose of rocuronium than previously reported could provide similar intubating conditions to suxamethonium during rapid-sequence induction of anaesthesia in children.

Methods: One hundred and twenty ASA I, unpremedicated children, aged 1-10 years, who were undergoing elective surgery, were randomized into three groups to receive rocuronium 0.6 mg.

Ropivacaine undergoes slower systemic absorption from the caudal epidural space in children than bupivacaine.

Unlabelled: We compared the systemic absorption of ropivacaine and bupivacaine after caudal epidural administration in children. Twenty ASA physical status I or II children aged 1-7 yr undergoing elective hypospadias repair were randomized after the induction of general anesthesia to receive a single caudal epidural injection of 2 mg/kg of either ropivacaine 0.2% (R) or bupivacaine 0.