Objectives:This study was conducted to evaluate the effect of tranexamic acid (TA) on the intra-operative bleeding during the functional endoscopic sinus surgery (FESS) in children.Methods:A total of 100 children recruited to undergo FESS were randomized into two groups. Group I: Was given just after induction, intra-venous 25 mg/kg TA diluted in 10 ml of normal saline. Group II: Was given 10 ml of normal saline. Non-invasive blood pressure, heart rate, and quality of the surgical field were estimated every 15 min. Volume of bleeding and duration of the surgical procedure were recorded.Results:Surgical field quality after 15 min revealed that seven patients in group I had minimal bleeding versus no one in group II, P=0.006. Meanwhile, 35 patients in group I had mild bleeding versus 26 patients in group II, P=0.064. Higher number of patients in group II than in group I had moderate bleeding, P=0006. Also, at 30 min, revealed that 10 patients in group I had minimal bleeding versus one patient in group II, P=0.004. Meanwhile, 37 patients in group I had mild bleeding versus 28 patients in group II, P=0.059. Higher number of patients in group II than in group I had moderate bleeding, P<0001. Duration of the surgeries and volume of bleeding were significantly less in tranexamic group than the placebo group, P<0.0001.Conclusion:Single intra-venous bolus dose of tranexamic in children during the FESS improves quality of surgical field, reduces intra-operative bleeding, and duration of surgery.
Background and Aims:This study was conducted to determine the effectiveness of intravenous (IV) granisetron in the prevention of hypotension and bradycardia during spinal anesthesia in cesarean delivery.Material and Methods:A total of 200 parturients scheduled for elective cesarean section were included in this study. They were randomly divided into two groups. Group I was given 1 mg granisetron diluted in 10 ml normal saline slowly IV, 5 min before spinal anesthesia. Group II was given 10 ml of normal saline, 5 min before spinal anesthesia. Mean arterial blood pressure and heart rate (HR) were recorded every 3 min until the end of surgery (for 45 min). The total consumption of vasopressors and atropine were recorded. Apgar scores at 1 and 5 min were also assessed.Results:Serial mean arterial blood pressure and HR values for 45 min after onset of spinal anesthesia were decreased significantly in group II, P < 0.0001. The incidence of hypotension after spinal anesthesia was 64% in group II and 3% in group I (P < 0.0001). The total doses of ephedrine (4.07 ± 3.87 mg vs 10.7 ± 8.9 mg, P < 0.0001), phenylephrine (0.0 microg vs 23.2 ± 55.1 microg, P < 0.0001), and atropine (0.0 mg vs 0.35 ± 0.49 mg P < 0.0001) consumed in both the groups respectively, were significantly less in group I versus group II.Conclusion:Premedication with 1 mg IV granisetron before spinal anesthesia in an elective cesarean section significantly reduces hypotension, bradycardia and vasopressors usage.
Shivering during spinal anaesthesia has been well described, although it has a lower incidence in children over one year of age (10 to 16%) 1,2 than in adults (40 to 60%) 3. Post-anaesthetic shivering increases patient discomfort, may aggravate postoperative pain and increases oxygen utilisation. The neurotransmitter serotonin (5-HT3) plays a role in the control of perioperative shivering by its action in the pre-optic anterior hypothalamic region 4-6. The 5-HT3 receptor antagonists are effective in reducing post-anaesthetic shivering after general and spinal anaesthesia in adults 7,8. However, there is less information on their efficacy in reducing shivering after spinal anaesthesia in children, although it would be reasonable to assume antiserotonin drugs are effective in preventing this side-effect in this age group. In particular, there are no data on the effect of granisetron on postoperative shivering in the paediatric patient population. This study aimed to test the hypothesis that pretreatment with intravenous granisetron would be effective in reducing postoperative shivering after spinal anaesthesia in children aged two to five years. MATERIALS AND METHODS This study was approved by the institutional ethics committee of the Faculty of Medicine, Tanta University, Egypt (approval number 124/ 04/ 10) and written informed consent was obtained from the parents of all patients studied. This study was registered in the Australian New Zealand Clinical Trials Registry (ACTRN12611001059954). Eighty children, American Society of Anesthesiologists physical status I to II, aged two to five years and scheduled for lower limb surgery under spinal anaesthesia were entered into this double-blind, randomised, placebo-controlled trial. Exclusion criteria included parental refusal of consent, coagulopathy, spinal congenital anomalies, neurological abnormality, allergy to local anaesthetics, surgery scheduled to last for more than 90 minutes, hypo-or hyperthyroidism and those who needed an intraoperative blood transfusion. Patients were randomised to one of two groups to receive either granisetron 10 µg/kg intravenously diluted in 10 ml saline, or 10 ml saline (placebo group). Randomisation was performed using a computer-based random number generator in permutated blocks of varying sizes and the assignment entered in sealed envelopes that were not opened until informed consent was obtained. The drug was mixed and administered by a nurse who took no further part in the study. The patient, parent, anaesthetist, observer gathering data and nurses taking care of the patient in the perioperative period remained blinded to the group assignment.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.