Efeito de duas doses diferentes de dexmedetomidina na incidência de agitação ao despertar após cirurgia para correção de estrabismo: um ensaio clínico randômico

Background and objective

Emergence agitation is a postoperative negative behavior that affects mainly children. We studied the effect of two different doses of dexmedetomidine on the incidence and degree of EA in children undergoing strabismus surgery.

The perioperative course and anesthetic challenge for cytoreductive surgery with hyperthermic intraperitoneal chemotherapy

BackgroundCytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) by the closed technique provide a promising therapeutic option for highly selected patients with peritoneal carcinomatosis. CRS with HIPEC is a long and complex procedure with significant blood and fluid loss, hemodynamic, hematological, and metabolic alterations in the perioperative period, with resultant morbidity and mortality. This work was done to evaluate our early experience in anesthesia and early postoperative care for these cases.Patients and methodsThis retrospective study was done on 13 patients for CRS and HIPEC, with intraoperative and early postoperative recording and evaluation of the fluid and blood losses and replacement, changes in hemodynamic, metabolic, and respiratory parameters and any complications happened.ResultsOur data demonstrated high fluid and blood losses during CRS. During HIPEC, raised body temperature, increased central venous pressure and airway pressure, increased arterial partial carbon dioxide tension (PaCO₂), decreased ratio of arterial oxygen partial pressure/fractional inspired oxygen (P_aO₂/F_iO₂), and increased serum lactate were recorded. These were associated with hemodynamic, metabolic, and respiratory acidosis. The patients were continuing resuscitation and correction of any derangements in intensive care unit.ConclusionCRS and HIPEC have become standard treatment for certain peritoneal surface malignancies. This extended surgery is considered a challenge for the anesthetist. It is associated with relevant fluid, blood, and protein losses, together with hemodynamic, respiratory, and metabolic derangements. However, these derangements are short lived and could be controlled by continuous monitoring and rapid intervention.     

Postoperative sterile endophthalmitis (TASS) associated with the memorylens

PURPOSE: To report 10 cases of delayed-onset acute intraocular inflammation following cataract extraction and posterior chamber implantation of the MemoryLens(R) intraocular lens (IOL). SETTING: John A. Moran Eye Center, Department of Ophthalmology, University of Utah, Salt Lake City, Utah, USA. METHODS: This retrospective study evaluated 10 cases of postoperative inflammation that occurred after cataract extraction with placement of the posterior chamber MemoryLens IOL. Protocols of the Intermountain Ocular Research Center used to analyze outbreaks of unexplained postoperative inflammation as well as medical records were reviewed. RESULTS: Nine patients had uneventful cataract extraction and 1 had a small anterior capsule tear with placement of the MemoryLens IOL. All 10 patients presented with increased anterior segment inflammation a mean of 7.8 days (range 1 to 21 days) after surgery. Three cases were tapped and were culture negative, and 7 were presumed noninfectious. The anterior segment inflammation improved in all patients. Treatment of the 7 patients included intensive topical steroids. Careful analysis of the inflammation has not revealed an obvious etiology; however, the MemoryLens was associated with all the cases. CONCLUSIONS: We postulate that these cases of noninfectious postoperative endophthalmitis may be associated with the MemoryLens.     

Hypolipidaemic activity of seaweed from Karachi coast

During the present study, ethanol extracts of five seaweed species Solieria robusta, Iyengaria stellata, Colpomenia sinuosa, Spatoglossum asperum and Caulerpa racemosa at 10 mg/ 200 g body weight were tested for their hypolipidaemic activity. All the species significantly decreased the serum total cholesterol, triglyceride and low density lipoprotein cholesterol levels in normal, triton-induced and diet-induced hyperlipidaemic rats. Solieria robusta was found to be the most effective in reducing the lipid profile, particularly in diet-induced hyperlipidaemic rats. A beneficial effect of the ethanol extract of S. asperum was also found on cardiac and liver enzymes in diet-induced hyperlipidaemic rats.     

Management of simultaneously ingested and aspirated foreign bodies in an infant

This report describes the management of a 7-month-old baby who aspirated one and ingested two paper pins at a time. Bronchoscopic removal was done for aspirated pin and ingested pins were observed for spontaneous passage in stool, which occurred in 48 hours without any untoward incidence.     

Sirenomelia (Mermaid baby)

Sirenomelia is a rare anomaly that rarely occurs as an isolated lesion. Several theories have been proposed regarding the etiopathogenesis. In this communication, we report a case of sirenomelia. Our patient was referred to hospital at the age of four hours. On examination, fusion of both lower limbs with hook shaped appendage, attached distally, absent genitalia and absent anal orifice was found. Spine was deficient in sacral region. Upper torso looked normal. Baby also had frothing from mouth. Abdomen was non-distended. Feeding tube no.10 was tried to pass through mouth, which got obstructed at the level of upper esophagus that suggested oesophageal atresia. The skeletogram revealed absence of pelvic bones, sacral agenesis, absent fibulae and fracture of both femora. The patient died at the age of 12 hours.