Chronic Pain after Open Appendectomy and Its Effects on Quality of Life in Children Aged 8–18 Years

Background. Chronic postsurgical pain is an important problem for both children and adults. This study aims to investigate the prevalence of chronic postappendectomy pain (CPAP) in children and its social and physical effects. Methods. This prospective observational study was conducted on children aged 8–18 years who had undergone open appendectomies. In the sixth month after the surgical procedure, the presence of chronic pain was examined in the lower right abdominal area. CPAP and its effects on children’s daily life activities were assessed using the numeric rating scale (NRS) and the Pediatric Quality of Life Scale (PedsQL). Results. Analysis was performed on 158 children, 97 of whom were boys (61.4%) and 61 were girls (38.6%). The average age was 12.8 ± 3 years, the average NRS was 4.48 ± 1.1, and the average scar length was 6.09 ± 1.6 cm. Twenty-nine children described CPAP, and its prevalence at six months after the surgery was 18.4%. Of these, 16 (55.2%) complained of pain only during exercise and 13 (44.8%) experienced pain while resting. The rate of CPAP was significantly higher in girls. Female gender and longer scar length were associated with the development of chronic pain. The PedsQL scores from the children’s self-reports and their parents’ reports were significantly lower for children who described CPAP as compared to those without CPAP. Conclusion. CPAP occurs quite frequently in children, especially in girls, and negatively affects children’s quality of life

Effects of carbon dioxide insufflation on regional cerebral oxygenation during laparoscopic surgery in children: a prospective study

ABSTRACT BACKGROUND AND OBJECTIVES: Laparoscopic surgery has become a popular surgical tool when compared to traditional open surgery. There are limited data on pediatric patients regarding whether pneumoperitoneum affects cerebral oxygenation although end-tidal CO2 concentration remains normal. Therefore, this study was designed to evaluate the changes of cerebral oxygen saturation using near-infrared spectroscope during laparoscopic surgery in children. METHODS: The study comprised forty children who were scheduled for laparoscopic (Group L, n = 20) or open (Group O, n = 20) appendectomy. Hemodynamic variables, right and left regional cerebral oxygen saturation (RrSO2 and LrSO2), fraction of inspired oxygen, end-tidal carbon dioxide pressure (PETCO2), peak inspiratory pressure (Ppeak), respiratory minute volume, inspiratory and end-tidal concentrations of sevoflurane and body temperature were recorded. All parameters were recorded after anesthesia induction and before start of surgery (T0, baseline), 15 min after start of surgery (T1), 30 min after start of surgery (T2), 45 min after start of surgery (T3), 60 min after start of surgery (T4) and end of the surgery (T5). RESULTS: There were progressive decreases in both RrSO2 and LrSO2 levels in both groups, which were not statistically significant at T1, T2, T3, T4. The RrSO2 levels of Group L at T5 were significantly lower than that of Group O. One patient in Group L had an rSO2 value <80% of the baseline value. CONCLUSIONS: Carbon dioxide insufflation during pneumoperitoneum in pediatric patients may not affect cerebral oxygenation under laparoscopic surgery

Simultaneous Spectrophotometric Determination Of Ezetimibe And Simvastatin In Pharmaceutical Preparations Using Chemometric Techniques

Two spectrophotometric methods are described for the simultaneous determination of ezetimibe (EZE) and simvastatin (SIM) in pharmaceutical preparations. The obtained data was evaluated by using two different chemometric techniques. Principal Component Regression (PCR) and Partial Least-Squares (PLS-1). In these techniques, the concentration data matrix was prepared by using the mixtures containing these drugs in methanol. The absorbance data matrix corresponding to the concentration data matrix was obtained by the measurements of absorbances in the range of 240 - 300 nm in the intervals with Delta lambda = 1 nm at 61 wavelengths in their zero order spectra, then, caliberation or regression was obtained by using the absorbance data matrix and concentration data matrix for the prediction of the unknown concentrations of EZE and SIM in their mixture. The procedure did not require any separation step. The linear range was found to be 5 - 20 mu g mL(-1) for EZE and SIM in both methods. The accuracy and precision of the methods were assessed. These methods were successfully applied to a pharmaceutical preparation, tablet; and the results were compared with each other.Wo

Effects of Sugammadex and Neostigmine on Renal Biomarkers.

Neostigmine, the currently commonly used agent for reversal of neuromuscular blockade. Sugammadex is a novel and unique compound designed as an antagonist of steroidal neuromuscular blockers. In this study, we evaluated the effects of sugammadex or neostigmine on kidney functions in patients scheduled for elective surgery

Effects of Sugammadex and Neostigmine on Renal Biomarkers

Background: Neostigmine, the currently commonly used agent for reversal of neuromuscular blockade. Sugammadex is a novel and unique compound designed as an antagonist of steroidal neuromuscular blockers. In this study, we evaluated the effects of sugammadex or neostigmine on kidney functions in patients scheduled for elective surgery. Material/Methods: Patients scheduled for a surgical procedure under desflurane/opioid anesthesia received an intubating dose rocuronium. Patients were divided into 2 groups receiving either sugammadex or neostigmine atropine to reverse neuromuscular blockade. Cystatin C, creatinine, urea, blood urea nitrogen, sodium, potassium, and calcium levels in the blood and alpha(1)microglobulin, beta(2)microglobulin, and microalbumin levels in the urine were measured. Results: There was no significant difference between the groups with regard to the demographic data. In the Neostigmine Group, although beta(2)microglobulin and microalbumin were similar, a significant increase was found in the postoperative alpha(1)microglobulin and cystatin C values. In the Sugammadex Group, although beta(2)-microglobulin and cystatin C were similar, a significant increase was found in the postoperative alpha(1)-microglobulin and microalbumin values. The only significant difference was cystatin C value variation in the Neostigmine Group compared to the Sugammadex Group. Conclusions: We believe that the use of more specific and sensitive new-generation markers like cystatin C to evaluate kidney function will provide a better understanding and interpretation of our results. Sugammadex has more tolerable effects on kidney function in patients than does neostigmine. However, when compared to preoperative values, there is a negative alteration of postoperative values. Neostigmine and sugammadex do not cause renal failure but they may affect kidney function