Anesthetic Management of Rapid Ventricular Response Atrial Fibrillation in an Elderly Woman Using Remifentanil; A Case Report

Atrial fibrillation (AF) is the most common cardiac Arrhythmia in all clinical settings. In the setting of atrial fibrillation with rapid ventricular response (AFib with RVR), early rate control (with or without restoration of the sinus rhythm) is the center of management. Several drugs are used for the management of rapid ventricular response AF but the optimal one is unknown yet. In this case report we present an elderly woman undergoing urgent ophthalmic surgery whose rapid ventricular response AF was controlled by Remifentanil

Familial Dysautonomia, Report of 3 Cases from Iran and a Discussion about Their General and Anaesthesia Care

Background: Familial Dysautonomia (FD) is a rare hereditary syndrome which is an autosomal recessive trait that typically affects Jewish children. Important signs and symptoms of the disorder include; diminished pain perception, absence of overflow tears, hypotonia, fainting cardiac arrhythmias and autonomic crisis.Cases Report: In this article we reported 3 cases of FD syndrome which had presented for surgical operation followed by a discussion about general care of these patients as well as Anesthesia considerations

Incidence of Oculocardiac Reflex in Pediatric Population Undergoing Corrective Strabismus Surgery: Comparison between Sevoflurane and Total Intravenous Anesthesia

Background: Oculocardiac reflex (OCR) is a life threatening, possible complication of corrective strabismus surgery and is more common among the pediatric patients. Sevoflurane and Propofol are the most commonly used agents in pediatric surgery. This study aimed to compare the effect of these two agents on oculocardiac reflex during corrective strabismus surgery in pediatrics patients.Materials and Methods: A total of 89 children were divided in two groups and no significant demographic data difference was between the two groups. Group 1 (n=45) received sevoflurane 6-8% as induction agent followed by 2-3% for maintenance, group 2 (n=44) was injected with propofol 3mg/kg as induction agent followed by 200µg/kg/min infusion as the maintenance dose, bispectral index (BIS) was kept 40-60 in both groups. Oculocardiac reflex was compared between the two groups.Results: Incidence of OCR of group 1was showed a significant decrease.Conclusion: Sevoflurane reduced the incidence of OCR. Sevoflurane may be the agent of choice in corrective strabismus surgery, compared to propofol

Phantom Limb Sensation (PLS) and Phantom Limb Pain (PLP) among Young Landmine Amputees

How to Cite This Article: Poor Zamany Nejat Kermany M, Modirian E, Soroush M, Masoumi M, Hosseini M. Phantom Limb Sensation (PLS) and Phantom Limb Pain (PLP) Among Young Landmine Amputees. Iran J Child Neurol. Summer 2016; 10(3):42-47. AbstractObjectiveTo determine the frequency of phantom limb sensation (PLS) and phantom limb pain (PLP) in children and young adults suffering landmine-related amputation.Materials & MethodsAll youths with amputation due to landmine explosions participated in this study. The proportions of patients with phantom limb sensation/pain, intensity and frequency of pain were reported. Chi square test was used to examine the relationship between variables. Comparison of PLP and PLS between upper and lower amputation was done by unpaired t-test.ResultsThere were 38 male and 3 female with the mean age of 15.8±2.4yr. The mean interval between injury and follow-up was 90.7±39.6 months. Twelve (44.4%) upper limb amputees and 11 (26.8%) lower limb amputees had PLS. Nine (33.3%) upper limb amputees and 7 (17.1%) lower limb amputees experienced PLP. Of 27 upper limb amputees, 6 (14.6%) and among 15 lower limb amputees, 6 (14.6%) had both PLS and PLP. One case suffered amputation of upper and lower limbs and was experiencing PLS and PLP in both parts. PLS had a significant difference between the upper and lower amputated groups. Significant relationship was observed between age of casualty and duration of injury with PLP.ConclusionPhantom limb sensation and pain in young survivors of landmine explosions appear to be common, even years after amputation. References Nikolajsen L, Jensen TS. Phantom limb pain. Br J Anaesth 2001; 87:107-16.Tseng CC, Chen PY, Lee YC. Successful treatment of phantom limb pain and phantom limb sensation in the traumatic amputee using scalp acupuncture. Acupunct Med 2014;32(4):356-8.Davis RW. Phantom sensation, phantom pain, and stump pain. Arch Phys Med Rehabil 1993;74:79–91.Jensen TS, Krebs B, Nielsen J, Rasmussen P. 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Mental health disorders in child and adolescent survivors of post-war landmine explosions.

BACKGROUND: To describe the mental health status of 78 child and adolescent survivors of post-war landmine explosions. METHODS: Child and adolescent survivors of landmine explosions who were younger than 18 years old at the time of the study were identified and enrolled in this study. The mental health status of the participants was assessed by general health assessment and psychiatric examinations. Psychiatric assessment and diagnosis were undertaken using the Diagnostic and Statistical Manual for mental disorders (DSM-IV) criteria. A psychiatrist visited and interviewed each survivor and identified psychiatric disorders. RESULTS: Seventy-eight child and adolescent survivors with a mean age of 16.11 ± 2 years old were identified and agreed to participate in the study. The mean age of the victims at the time of injury was 8.2 ± 3.12 years old (range 2-15). Thirty-seven (47.4 %) of the adolescent survivors suffered from at least one psychiatric disorder. Twenty-nine survivors (37.1 %) were newly diagnosed and needed to start medication and psychiatric treatment. The most common findings were anxiety disorders (34.6 %), including posttraumatic stress disorder (PTSD) in 20 (25.6 %), and generalized anxiety disorder (GAD) in 7 (9 %) subjects. Mild-Moderate depression was found in 5 (6.4 %) subjects. No personality disorders were observed, and two patients suffered from mental retardation. The study results revealed a significant association between age of casualty, duration of injury and limb amputation, and types of psychological disorders. CONCLUSION: Child and adolescent survivors of landmine explosions had a high prevalence of psychiatric disorders