Amaç: Postoperatif kusma genel anestezi sonrasında en sık karşıla-şılan problemlerden biridir. Etiyolojide pek çok faktörün tek başı-na veya birlikte etkili olduğu bilinmektedir. Akupunktur, Dünya Sağlık Örgütünün tamamlayıcı tedavi metodu olarak kabul ettiği bir medikal tekniktir. Burada çocuk hastalarda adenoidektomi ve/ veya tonsillektomi sonrasında görülen kusmanın tedavisi amacıyla Akupunktur deneyimimiz sunulmaktadır.Yöntemler: Çalışmaya genel anestezi altında adenoidektomi ve/ veya tonsillektomi uygulanan, 2-14 yaş arasında, ASA I-II, (n=70) hastalar dahil edildi. Hastalar çalışma ve kontrol grubu olarak, rastgele iki gruba ayrıldılar. Çalışma grubunda, akupunktur iğnesi intraoperatif dönemde 20 dakika P6 noktasında uygulandı. Gruplara postoperatif dönemde antiemetik herhangi bir tedavi verilmedi. Hastalar postoperatif dönemde grupları bilmeyen hemşireler tarafında takip edildi. Bulgular: Yaş, cinsiyet, girişim türü, anestezi süresi, girişim süresi, cerrahi uygulama ve ASA skorları göz önüne alındığında gruplar arasında istatistiksel olarak anlamlı farklılık saptanmadı. Grupların kusma sayıları karşılaştırıldığında ise anlamlı farklılık olduğu saptandı. Akupunktur uygulanan grupta kusma sıklığının diğer gruba göre 0,28 kat daha az olduğu görüldü.Sonuç: Çalışmamızın sonuçları, akupunktur uygulamasının postoperatif kusmayı azaltmada açık bir etkinliği olduğunu gös-termektedir. Akupunkturun rutin kullanımı postoperatif hasta konforuna katkıda bulunmanın yanısıra tedavi veya profilaksi amacıyla ilaç kullanımını azaltacaktır.Anahtar kelimeler: Akupunktur, postoperatif kusma, adenoidektomi, tonsillektomi Objective: Postoperative vomiting (POV) is one of the most common problems following general anaesthesia, and many factors, either solely or in combination, may play a role in aetiology. Acupuncture is a technique that the World Health Organization has accepted as a complementary treatment. This study presents our experience with acupuncture for POV treatment in a study of paediatric tonsillectomy cases. Methods:The study included ASA I-II patients (n=70) aged 2-14 years who underwent tonsillectomy and/or adenoidectomy under general anaesthesia. The patients were randomly divided into the following two groups: control and study group. In the study group, an acupuncture needle was intraoperatively applied to the P6 acupuncture point for 20 min. Antiemetics were not administered to either group because of the standard applications in the preoperative period. The patients were postoperatively evaluated by nurses who were unaware about the techniques used in either group.Results: No statistically significant difference was determined between the groups with regard to age, sex, nature of the operation, duration of anaesthesia, duration of the operation, surgical method and ASA scores. A statistically significant difference was determined between the groups with respect to vomiting rates. The acupuncture group presented with 0.28-times fewer vomiting episodes than the control group. Conclusion:The results of the stud...
Background: A difficult laryngoscopy in young children can be a stressful situation for the pediatric anesthetist. In recent years, several measurements have been used to obtain difficult laryngoscopy markers in children. However, there is no prospective study in which ultrasonography is expected to be used for this purpose, particularly in the newborn and infant age groups. Goals: In this study, our goal was to evaluate the relationship between the preoperative airway assessment tools and the difficult laryngoscopic view in neonates and infants. Methods: Our study included newborns and infants undergoing elective surgery requiring intubation under general anesthesia. The following measurements were recorded the following: patients' age, body mass index, thyromental distance, mandibular length, the distance between the lip corner and ipsilateral ear tragus, and the transverse length (measured by hand with sign-middle-ring fingers side by side). In the thyromental distance measurement, the "thyroid notch" was determined by ultrasonography. Glottic structures appearing during laryngoscopy were graded according to the Cormack-Lehane Classification. Results: Of the 150 patients included in the study, 36 were female, and 92% were under the age of one. The incidence of difficult laryngoscopic views was 8% in the age groups studied, and the frequency of difficult laryngoscopic views in the newborn age group was 14.3%. The relationship between airway assessment tools and the Cormack-Lehane Classification scores was statistically significant. The negative predictive value was high for all values. Conclusions: The risk of a difficult laryngoscopy increases in children under the age of one. The preoperative airway assessment tools and body mass index had acceptable negative predictive values. We believe that all measurements could be used as markers for difficult laryngoscopy in newborns and infants.
PurposeIn this study, we retrospectively investigated case reports with and without midazolam administration via oral, intranasal and rectal before cystometry procedure. We aimed to compare the data to evaluate the effects of sedation before cystometry on the pediatric patients and parents’ satisfaction.MethodsA total of 124 ASA I-II pediatric cases aged 5–14 years were retrospectively investigated from the hospital records. One of the three administration routes was chosen; oral midazolam at a dose of 0.5 mg/kg and nasal or rectal midazolam at a dose of 0.3 mg/kg (maximum 15 mg). Heart rate, blood pressure, oxygen saturation, the Wisconsin Hospital of Children Sedation Scale (CHWSS) score and the Groningen Distress Rating Scale (GDRS) score were recorded. Cystometry measurement values, diagnoses of the cases and procedure durations were recorded from the urodynamic laboratory records.Results80 female, 44 male cases were evaluated. The CHWSS score at the 10th and 20th minutes after the drug administeration was higher in the oral group than the others (p = 0.001). The duration between the administration of the drug and the start of the procedure was shorter in the nasal group (p = 0.01). Parents satisfaction for sedation was 77 % when comparison of the cystometry with and without sedation. Comparison of the cystometry results with or without sedation no significant difference was found between all parameters (p > 0.01).ConclusionWe believe that sedation with midazolam administered through all three routes is a safe, effective and convenient option during cystometry, especially in the young age group.
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