Background: Children with brain tumors experience potential neurologic complications when are treated with radiotherapy, especially if done frequently under anesthesia. Objectives: This study aimed to evaluate the neurologic complications associated with anesthesia in pediatrics treated with radiotherapy under anesthesia. Methods: This cross-sectional study consisted of 133 pediatric patients with a brain tumor who needed anesthesia for performing radiotherapy and were referred to Omid Charity Hospital and Imam Khomeini University Hospital from 2014 to 2020 by the census. Statistical values less than 0.05 were considered significant (P < 0.05). Results: The patients were in range of 1 - 8 years, and the number of 3,208 anesthesia inductions were conducted for daily radiotherapy. Major complications such as stroke, arrhythmia, tachyphylaxis, and aspiration were not observed. There was a significant relationship between the tumor side, anesthesia, and neurologic complications (P < 0.05). No significant differences were found between demographic data (age, sex, and weight) (P > 0.05). Conclusions: Anesthesia complications in this study were slight and insignificant. Some were either due to the tumor effect on other vital organs or prior exposure to radiotherapy and chemotherapy. Thus, for providing safe anesthesia, considering the tumor effect on body organs and neurologic complications caused by it can be a great help to reduce anesthesia complications in pediatrics under radiotherapy.
Purpose: To evaluate the early effects of panretinal photocoagulation (PRP) on corneal sensation and dry eye signs in patients with diabetic retinopathy. Methods: Fifty patients with Type 2 diabetes mellitus and very severe nonproliferative or non–high-risk proliferative diabetic retinopathy who required PRP for the treatment of their retinal condition were enrolled. All patients were treated using a pattern PRP device. Esthesiometry, tear breakup time test, Schirmer test, and corneal staining pattern were evaluated at baseline and 2 months after the last session of PRP. Results: Data from 88 eyes of 50 patients (41 right eyes and 47 left eyes) were analyzed. The mean tear breakup time test (right eyes) was decreased from 9.51 at baseline to 7.66 seconds after PRP (P < 0.001). The post-PRP eyes showed more advanced grades of corneal staining than pre-PRP assessment (P < 0.001). The average value of Schirmer test was 14.39 versus 12.29 mm (without anesthesia; P < 0.001) and 8.17 versus 7.15 mm (with anesthesia, P < 0.001) for baseline versus post-PRP measurements, respectively. The corneal sensation also showed decrease after laser therapy (4.93 versus 4.31 cm; P < 0.001). Conclusion: This study demonstrates that decreased corneal sensation and signs of dry eye are more common immediately after PRP for diabetic retinopathy. These conditions should be discussed with the patient preoperatively and managed postoperatively.
Background: Tonsillectomy is one of the most common surgical procedures. This study compared the effect of Pregabalin and Clonidine on postoperative pain in adult patients undergoing elective tonsillectomy. Methods: This randomized, double-blind, prospective clinical trial was conducted among 92 patients aged 20 to 50. The clonidine group (C) was given 150 µg of clonidine tablet 90 minutes before surgery, and the pregabalin group (P) was given 300 mg of pregabalin tablet 90 minutes before surgery. The results were analyzed by SPSS 25, and statistical analysis consisted of chisquare, T-test, and χ2 tests, and a p-value less than 0.05 was considered significant. Results: The mean pain score and analgesic consumption scores in the pregabalin group were lower than in the clonidine group. According to the t-test, there was a significant difference between the two groups regarding pain score and analgesic consumption (p <0.05). Hemodynamic variation in both groups had no significant differences (p >0.05). Conclusion: The present study showed that pregabalin reduced postoperative pain and analgesic consumption more effectively than clonidine.
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