This study was designed to determine whether administration of caudal bupivacaine with fentanyl would have any effect on analgesia in paediatric patients undergoing inguinal herniorrhaphy repair. Fifty-six outpatient paediatric patients undergoing inguinal hernia repair were evaluated. Patients received, in a randomized manner, 1 ml.kg-1 of either bupivacaine 0.25% or 0.125% with or without fentanyl 1 microg.kg-1. There was no difference in pain scores in the hospital, the night of surgery, or 24 h postoperatively nor was there a difference in the oral analgesics administered between any of the groups. There was a higher incidence of vomiting at home in both 0.25% bupivacaine groups irrespective of the use of fentanyl. The 0.125% bupivacaine group had significantly more patients who received intravenous fentanyl in the PACU than did the other three groups (P<0.001). Increasing the concentration of bupivacaine from 0. 125% to 0.25% increased the incidence of postoperative vomiting. We recommend that clinicians utilize bupivacaine 0.125% with 1 microg. kg-1 fentanyl as the caudal injectate in paediatric patients undergoing inguinal hernia repair.
Near the end of this exciting new book, Simon Rowedder recounts a favorite line of one of his regular informants, a cross-border petty trader named Amnuay: 'Soon, northern Laos will be part of southern China.' By this point in the book, it is clear that neither Amnuay nor the author mean by this the simple trope of Chinese neo-colonial ambition that many outside observers (both academic and otherwise) have looked to the borderlands of northern Laos for evidence of. Rather, his informant's linedelivered with what he describes as a mischievous, meaningful smile-gestures in multiple directions: 'a simple joke, anger, uncertainty, fear, worry, fatalism, resilience, pragmatism, and aspiration [all] at the same time'. Such is the richness of Rowedder's book that this anecdote, playing with but also exploding familiar invocations of Global China, caps a powerful yet understated narrative that spans the borderlands of the upper Mekong region, locating the region's dynamism not in grand narratives of state power, diplomacy or infrastructure, but in the everyday cosmopolitanism of transnational Lao traders like Amnuay.Cross-Border Traders in Northern Laos: Mastering Smallness is based on extensive fieldwork conducted intermittently between 2015 and 2019 in Laos, China and Thailand, and drawing on the author's impressive linguistic dexterity in all three national languages, as well as various local dialects. Focusing on Lao traders, Rowedder follows a handful of informants through the borderlands of all three countries, focusing on what he calls the banal cosmopolitanism of petty trade in places like Jinghong (China), Ban Huay Meng (a major Thai fruit-producing town in Chiang Rai), and Luang Namtha (Laos). The book's central intervention-the 'mastering smallness' in its subtitle-is twofold. It is, first, a recentering of petty trade and associated ('banal') cosmopolitanism in theorizing the transnationalization of the Sino-Southeast Asian borderlands. In focusing on towns, marketplaces and urban consumers rather than upland landscapes, large-scale infrastructure and grand visions of top-down planning, Rowedder is explicitly 'taking issue with worlds of larger representations' (p. 26) of the region's dynamics, whether these emphasize Chinese neo-colonialism and the Belt & Road Initiative (etc.) or exemplify what he calls the 'Zomian baggage' that weighs so heavily on many scholarly accounts of the region (p. 38).A second dimension of Rowedder's interest in 'smallness' emerges from the first. This is the attention to marketplace interactions, via what he calls 'careful ethnographic observation of the ways in which small-scale traders utter and perform smallness' (p. 31, emphasis in original). Through these observations, Rowedder shows how Lao traders' practising of smallness-while sometimes humble and at times appearing selfdeprecating or even ignorant (e.g. of Chinese language)-is in fact strategically deployed tradecraft, through which Lao traders have created and maintained an often profitable (if sometimes precarious) ni...
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