These data suggest that, in addition to underlying clinical conditions, some invasive procedures can be independent risk factors for nosocomial infection in ICU.

Intravenous administration of low dose ketamine before induction and maintenance with propofol preserves hemodynamic stability without changing the duration and the quality of recovery compared with propofol alone.

Hypotension during induction of anesthesia with propofol is common. This study has shown that propofol requirement assessed by bispectral index analysis during anesthesia induction may decrease the dose and side effects and provide for satisfactory depth of anesthesia.

P Pu ur rp po os se e: : To compare tramadol alone and the combinations of either tramadol-clonidine or tramadol-droperidol with regard to analgesic and adverse effects.M Me et th ho od ds s: : After Ethic's Committee approval and patient informed consent were obtained, epidural catheters were inserted preoperatively at the L 3-4 interspace in 90 ASA physical status I-II adult patients undergoing lower abdominal surgery. Anesthesia was standardized. Patients were randomly assigned to one of three groups. Group I (T) patients received tramadol 75 mg, Group II (TD) patients received tramadol 75 mg plus droperidol 2.5 mg, and Group III (TC) patients received tramadol 75 mg plus clonidine 150 µg in a total volume of 10 mL administered as a single epidural injection in the postanesthesia care unit. The onset time of analgesia and duration of analgesia, visual analogue pain scores, sedation, nausea scores, vital signs and side effects were recorded. R Re es su ul lt ts s: : Duration of analgesia was similar in both the TD and TC groups, and significantly longer than in the T group (P < 0.001). Group TC patients displayed a significant increase in sedation scores and decrease in blood pressure and heart rate when compared with other groups (P < 0.001). No adverse effects were observed in Group TD, while nausea scores were high in both the T and TC groups (P < 0.001). Pain score, respiration rate, and SpO 2 values were similar in all study groups.C Co on nc cl lu us si io on n: : We conclude that epidural tramadol in combination with droperidol or clonidine prolongs the duration of analgesia; however, droperidol appears to be a better alternative when adverse effects and antiemetic properties are taken into consideration. Objectif : Comparer le tramadol à la combinaison de tramadol-clonidine ou de tramadol-dropéridol en regard de leurs effets analgésiques et indésirables. Méthode : Ayant obtenu l'approbation du Comité d'éthique et le consentement éclairé des patients, nous avons réalisé l'insertion préopéra-toire d'un cathéter péridural dans l'espace intercostal L 3-4 chez 90 patients adultes d'état physique ASA I-II devant subir une intervention abdominale basse. L'anesthésie a été normalisée. Les patients ont été répartis en trois groupes de façon aléatoire. Ceux du groupe I (T) ont reçu 75 mg de tramadol, ceux du groupe II (TD), 75 mg de tramadol et 2,5 mg de dropéridol et du groupe III (TC), 75 mg de tramadol plus

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