Background: Dexmedetomidine (DEX) is a highly selective a 2 -adrenoceptor agonist that has been used increasingly in children. However, the effect of caudal DEX has not been evaluated before in children. This prospective randomized double-blinded study was designed to evaluate the analgesic efficacy of caudal DEX with bupivacaine in providing pain relief over a 24-h period. Methods: Sixty children (ASA status I) aged 1-6 years undergoing unilateral inguinal hernia repair/orchidopexy were allocated randomly to two groups (n 5 30 each). Group B received a caudal injection of bupivacaine 2.5 mg/ml, 1 ml/kg; Group BD received the same dose of bupivacaine mixed with DEX 1 mg/kg during sevoflurane anesthesia. Processed electroencephalogram (bispectral index score), heart rate, blood pressure, pulse oximetry and end-tidal sevoflurane were recorded every 5 min. The characteristics of emergence, objective pain score, sedation score and quality of sleep were recorded post-operatively. Duration of analgesia and requirement for additional analgesics were noted.

P Pu ur rp po os se e: : To compare three anxiety scales; the anxiety visual analogue scale (VAS), the anxiety component of the Amsterdam preoperative anxiety and information scale (APAIS), and the state portion of the Spielburger state-trait anxiety inventory (STAI), for assessment of preoperative anxiety levels in same day admission patients.M Me et th ho od ds s: : Patients completed the three anxiety assessment scales both before and after seeing the anesthesiologist preoperatively. The scales used were the STAI, the six-question APAIS, and the VAS. APAIS was further subdivided to assess anxiety about anesthesia (sum A), anxiety about surgery (sum S) and a combined anxiety total (i.e., sum C = sum A + sum S). These scales were compared to one another. Pearson's correlation (pair-wise deletion) was used for validity testing. Cronbach's α analysis was used to test internal validity of the various components of the APAIS scale. A correlation co-efficient (r) $ 0.6 and P < 0.05 were considered significant. R Re es su ul lt ts s: : Four hundred and sixty three scale sets were completed by 197 patients. There was significant and positive correlation between VAS and STAI r = 0.64, P < 0.001), VAS and APAIS r = 0.6, P < 0.001), sum C and STAI r = 0.63, P < 0.001) and between VAS and sum C r = 0.61, P < 0.001). Sum C and STAI r value were consistent with repeated administration. Cronbach's α-levels for the anxiety components of the APAIS (sum C) and desire for information were 0.84 and 0.77 respectively. C Co on nc cl lu us si io on n: : In addition to VAS, the anxiety component of APAIS (sum C) is a promising new practical tool to assess preoperative patient anxiety levels. EVA et STAI, r = 0,64, P < 0,001); entre EVA et APAIS, r = 0,6, P < 0,001); entre la somme C et STAI, r = 0,63, P < 0,001) et entre EVA et la somme C, r = 0,61, P < 0,001 Objectif Méthode : Pour tous les patients, les trois échelles d'évaluation de l'anxiété ont été utilisées avant et après la rencontre préopératoire avec l'anesthésiologiste. Ce sont la STAI, les six questions de l'APAIS et l'EVA. Le questionnaire APAIS a été ensuite subdivisé pour évaluer l'anxiété concernant l'anesthésie (somme A), l'anxiété concernant l'opération (somme O) et l'anxiété totale combinée (somme C = somme A + somme O). Ces échelles ont été comparées les unes aux autres. La corrélation de Pearson (suppression par paires) a été utilisée pour la validité de l'épreuve. L'analyse α de Cronbach a servi à tester la validité interne des diverses composantes de l'échelle APAIS. Un coefficient de corrélation (r)$

Background: Review of post-operative morbidity reports for pediatric dental care under general anesthesia (GA) show great variations. Until now, no morbidity data has been available to estimate the safety of pediatric patients under GA for dental rehabilitation in Saudi Arabia. The purposes of this study were to (1) investigate post-operative complications associated with dental care under GA and (2) correlate morbidity reports with patient's characteristics, dental procedures, and hospital protocol.

We compared biologically variable ventilation (V (bv); n = 9) with control mode ventilation (V (c); n = 8) at low tidal volume (VT)--initial 6 ml/kg--in a porcine model of acute respiratory distress syndrome (ARDS). Hemodynamics, respiratory gases, airway pressures, and VT data were measured. Static P-V curves were generated at 5 h. Interleukin (IL)-8 and IL-10 were measured in serum and tracheal aspirate. By 5 h, higher Pa(O(2)) (173 +/- 30 mm Hg versus 119 +/- 23 mm Hg; mean +/- SD; p < 0.0001 group x time interaction [G x T]), lower shunt fraction (6 +/- 1% versus 9 +/- 3%; p = 0.0026, G x T) at lower peak airway pressure (21 +/- 2 versus 24 +/- 1 cm H(2)O; p = 0.0342; G x T) occurred with V (bv). IL-8 concentrations in tracheal aspirate and wet:dry weight ratios were inversely related; p = 0.011. With V (c), IL-8 concentrations were 3.75-fold greater at wet:dry weight ratio of 10. IL-10 concentrations did not differ between groups. In both groups, ventilation was on the linear portion of the P-V curve. With V (bv), VT variability demonstrated an inverse power law indicating fractal behavior. In this model of ARDS, V (bv) improved Pa(O(2)) at lower peak airway pressure and IL-8 levels compared with V (c).