Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
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Otolaryngol Head Neck Surg · Jan 2010
Randomized Controlled TrialOptimizing the surgical field in pediatric functional endoscopic sinus surgery: a new evidence-based approach.
To conduct the first prospective randomized controlled study 1) evaluating the possibility of improving the quality of the operative field and to provide a bloodless functional endoscopic sinus surgery (FESS) in children through total intravenous anesthesia (TIVA) using remifentanil combined with propofol, and 2) testing the safety and efficacy of remifentanil in propofol-TIVA in inducing controlled hypotension in children at a target mean arterial blood pressure of 50 mm Hg. ⋯ Improving the quality of the surgical field and providing a bloodless FESS in children is attainable with TIVA. TIVA using a combination of remifentanil and propofol is superior to BA, even with the use of additional potent hypotensive agents such as esmolol. Both techniques are safe and effective in inducing controlled hypotension in children at a target mean arterial blood pressure of 50 mm Hg.
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Otolaryngol Head Neck Surg · Dec 2009
Randomized Controlled TrialAntiemetic efficacy of dexamethasone combined with midazolam after middle ear surgery.
To evaluate the antiemetic efficacy of dexamethasone combined with midazolam after middle ear surgery. ⋯ The combination of dexamethasone and midazolam was better than dexamethasone alone in reducing the incidence of vomiting and the rescue antiemetic requirements in women patients undergoing middle ear surgery. However, this combination treatment did not significantly decrease the overall incidence of nausea and vomiting compared with the use of dexamethasone alone.
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Otolaryngol Head Neck Surg · Nov 2009
Readability analysis of patient information on the American Academy of Otolaryngology-Head and Neck Surgery website.
To evaluate the readability of patient-oriented online health information (OHI) presented on the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) website. ⋯ This analysis has shown that the average reading level for each article on the AAO-HNS site was higher than the recommended sixth grade reading level. Although the AAO-HNS site is written at a higher level than that suggested for the general public, it is important to realize that readability is just one consideration in the evaluation of OHI comprehension. Physicians need to be cognizant of their patients' ability to read and comprehend written information and tailor their educational material appropriately.
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Otolaryngol Head Neck Surg · Oct 2009
Randomized Controlled TrialTopical clindamycin in post-adenotonsillectomy analgesia in children: a double-blind, randomized clinical trial.
Tonsillectomy, with or without adenoidectomy, is one of the most common surgical procedures in pediatric otolaryngology. Pain is the main cause of morbidity in the postoperative period, where it is serious in some cases, leading to odynophagia and resultant complications such as dehydration. We evaluated the effect of topical clindamycin in the reduction of oropharyngeal pain in children who underwent adenotonsillectomy. Secondary outcomes were otalgia, analgesic use, oral bacterial count, type of diet, secondary bleeding, vomiting, fever, and weight loss. ⋯ The use of topical clindamycin was beneficial in reducing pain on the first postoperative day, without effect on subsequent days. Future investigations could examine the use of topical clindamycin not only in the first 12 hours but also during five days of follow-up.