Addition of midazolam to continuous postoperative epidural bupivacaine infusion reduces requirement for rescue analgesia in children undergoing upper abdominal and flank surgery.

Study Objective: To investigate the effect of adding midazolam to continuous epidural infusion of bupivacaine for postoperative analgesia in children.

Design: Prospective, randomized, double-blind, controlled study.

Setting: Tertiary-care center.

Epidural butorphanol-bupivacaine analgesia for postoperative pain relief after abdominal hysterectomy.

Study Objective: To determine the efficacy of epidural butorphanol with and without bupivacaine in providing postoperative analgesia following abdominal hysterectomy.

Design: Randomized, double-blinded study.

Settings: Postoperative recovery area of a university-affiliated medical center.

A comparison of halothane and sevoflurane for bronchoscopic removal of foreign bodies in children.

The present study was designed to compare induction and recovery characteristics of sevoflurane and halothane for rigid bronchoscopy for removal of foreign bodies in tracheobronchial tree in children. Forty four children (age 1-4 years) were allocated randomly to two groups to receive either halothane (group H; n=22) or sevoflurane (group S; n=22) in oxygen. A graded inhalation technique was used with maximum inspiratory concentration of 5% for halothane and 8% for sevoflurane.

Comparison of butorphanol and thiopentone vs fentanyl and thiopentone for laryngeal mask airway insertion.

Study Objective: To compare laryngeal mask airway (LMA) insertion conditions using a combination of butorphanol and thiopentone vs fentanyl and thiopentone.

Design: Prospective, randomized, and double-blind study.

Setting: Operating theater.

Comparative evaluation of midazolam and ketamine with midazolam alone as oral premedication.

Background: Oral premedication with midazolam and ketamine is widely used in pediatric anesthesia to reduce emotional trauma and ensure smooth induction. However, various dosing regimens when used alone or in combination have variable efficacy and side effect profile. The aim of our study was to investigate and compare the efficacy of oral midazolam alone with a low-dose combination of oral midazolam and ketamine.

Comparison of regional nerve block to epidural anaesthesia in day care arthroscopic surgery of the knee.

Day care minimally invasive surgery demands minimal complications with anaesthesia. Nerve blocks are increasingly being employed for surgical procedures on the lower limb, and we attempted to evaluate their benefits and drawbacks in a prospective randomised study in patients undergoing knee arthroscopy. We compared the effectiveness, onset time, duration of analgesia, patient acceptance, failure rate and post-operative comfort of epidural anaesthesia (with 20 ml of 2% lidocaine with adrenaline 1 in 200000) and peripheral nerve blocks (combined 3-in-1 and sciatic nerve block, with 50 ml of 1% lignocaine with adrenaline 1 in 200000, using nerve stimulator).

Paramedian lumbar epidural catheter insertion with patients in the sitting position is equally successful in the flexed and unflexed spine.

Positioning for placement of an epidural catheter can be quite painful for patients with lower limb injuries. We randomly allocated 50 patients scheduled for surgery after lower limb injuries for placement of a lumbar epidural catheter in the sitting position with the back in the neutral unflexed position by either the midline or paramedian approach. If the approach failed after two attempts, patients were placed in a flexed-spine position, and the procedure was attempted again.

Prevention of nausea and vomiting after middle ear surgery: combination of ondansetron and dexamethasone is the right choice.

Objective: To determine the efficacy of a combination of ondansetron and dexamethasone in preventing postoperative nausea and vomiting after middle ear surgery compared with ondansetron alone.

Design: A prospective, randomized, double-blind study with prestudy power analysis performed to determine the sample size.

Setting: A tertiary teaching hospital.

Caudal neostigmine with bupivacaine produces a dose-independent analgesic effect in children.

Purpose: To evaluate the analgesic efficacy and duration of varying doses of caudal neostigmine with plain bupivacaine and its side effects in children undergoing genito-urinary surgery.

Methods: In a randomized double-blind prospective study 80 boys aged two to eight years scheduled for surgical repair of hypospadias were allocated randomly to one of four groups (n = 20 each) and received either only caudal 0.25% plain bupivacaine 0.

Comparison of ondansetron with ondansetron plus dexamethasone for antiemetic prophylaxis in children undergoing strabismus surgery.

Background: Children undergoing strabismus surgery have a high incidence of postoperative nausea and vomiting. Ondansetron plus dexamethasone is effective in reducing its incidence in many surgical procedures.

Purpose: To examine the efficacy of ondansetron plus dexamethasone in children undergoing strabismus surgery.

Difficult retrograde endotracheal intubation: the utility of a pharyngeal loop.

Unlabelled: Direct laryngoscopy and tracheal intubation remains the technique of choice to achieve control of the airway. Alternative or additional techniques of airway control are required whenever an airway is deemed difficult because of anatomical and/or technical reasons. The retrograde intubation technique is an important option for gaining airway access from below the vocal cords in such situations (1).