Pediatric surgery international
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Pediatr. Surg. Int. · Jun 2008
Randomized Controlled Trial Comparative StudyA comparison of analgesic efficacy of tramadol and pethidine for management of postoperative pain in children: a randomized, controlled study.
Prevention of postoperative pain in children is one of the most important objectives of the anesthesiologist. Opioids have been used as an analgesic for postoperative pain in children for many years. Tramadol has both opioid and monoaminergic agonist actions. ⋯ Sedation scores, heart rate and systolic and diastolic blood pressure showed no significant differences between the groups. We conclude that pethidine and tramadol are effective in providing analgesia in pediatric patients, but pethidine provided better postoperative analgesia than tramadol. Changes in blood pressure, heart rate and arterial oxygen saturation were minimal and were similar in both drugs.
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Pediatr. Surg. Int. · Jun 2008
Early complications of the Nuss procedure for pectus excavatum: a prospective study.
The Nuss procedure is a minimally invasive method for the correction of pectus excavatum, with several centers reporting its successful application. Complications related to the Nuss procedure are not uncommon and life-threatening complications have been reported. This study focuses on the incidence and management of complications in a series of 167 children and adults with funnel chest corrected by Nuss procedure. ⋯ Most minor complications can be avoided by changing the technique, e.g. fixation of the bar and the stabilizer onto the underlying rib, use of PDS cords instead of metal wires to fix the bar and the stabilizer, entrance into and exit of the thorax medial to the rim of the pectus excavatum, etc. Some complications are related to the technique, such as minor pleural effusion or remaining gas in the thorax. Clear guidelines in regard to the technique are presented to prevent the majority of complications and thereby shorten the learning curve.
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Pediatr. Surg. Int. · Jun 2008
Case ReportsUro-genital bleeding in pre-menarcheal girls: dilemmas of child abuse.
Uro-genital bleeding in pre-menarcheal girls always raises concerns regarding child abuse. There are serious social issues involved; however, before labeling it as sexual abuse, all efforts must be made to rule out an organic pathology. ⋯ On examination both had a rare condition of urethral prolapse. One of them underwent four-quadrant excision and the other was treated conservatively with urethral catherization.