Comparison of two warming methods in preventing perioperative hypothermia in children: forced air versus warmer

Introduction: Perioperative hypothermia is common during anesthesia and surgery and is accompanied by several complications. Compared to adults, children are at a greater risk of hypothermia and its complications. The aim of this study was to compare forced air and warmer in maintaining normothermia during pediatric surgery.Materials and Methods: This randomized controlled trial was performed on 90 children undergoing elective hernia repair equally distributed in three groups of warmer, forced air and control. Patients’ body temperature was recorded preoperatively, intraoperatively, at the end of surgery and at the end of the postoperative care unit (PACU) stay. Time between anesthetic discontinuation and tracheal extubation and duration of PACU stay were also noted.Results: Intraoperative and postoperative body temperature and body temperature on exit from PACU were significantly higher in forced air group in comparison to warmer and control groups and in warmer group in comparison to control group (P<0.05). Time between anesthetic discontinuation and tracheal extubation and duration of PACU stay were significantly shorter in forced air group compared to warmer and control groups and in warmer group compared to control group(P<0.05). Conclusion: In comparison between the two methods (Warmer vs. Forced air), we found that forced air was significantly more effective in maintaining normothermia during pediatric hernia repair

Evaluation of the effect of one-stage transanal endorectal pull-through (TERPT) technique on defecation in patients with Hirschsprung’s Disease over the last 10 years in Tehran Pediatrics Medical Center

Introduction: One-stage Transanal Endorectal Pull-Through (TERPT) is one of the methods used for the treatment of Hirschsprung’s disease. The purpose of our study was to evaluate complications of surgery specially does related to defecation in patients undergoing pull-through surgery in Tehran Pediatrics Medical Center during the past 10 years.Materials and Methods: This descriptive study was performed on patients undergoing one-stage TERPT operation in Tehran Pediatrics Medical Center over the past 10 years. Exclusion Criteria included: the parent’s lack of consent to participate in the study, age below 3 years and inability to complete the checklist. For all patients, a check list was completed that included: Age, family history of the disease, readmission, follow-up period, presence of soiling, complete or partial fecal incontinence, constipation, use of laxative, use of boogie, presence or absence of RectoAnal Inhibitory Reflex (RAIR) in manometers, stricture in rectal examination and enterocolitis before and after surgery. Data analysis was performed using SPSS software version 19.Results: Our patients were 4.81% male and 3.9% of them had an underlying disease, such as heart or kidney disease. Only 6.81% of them had to be re-admitted due to enterocolitis. Soiling was found in 5.39% of patients, complete and partial fecal incontinence were noted in 3.2% and 7.4% of them respectively. The incidence of fecal incontinency was 7%. Constipation occurred in 6.11% of cases and 3.9% of cases did not have RAIR in manometry. The incidence of rectal stenosis was 7% and 93% of patients had transitional zone (TZ) in barium enema before the operation. The result showed that there was no significant relationship between post- operative complications in both sexes (p<0.05).Conclusion: This study shows that the complications of Endorectal Transanal pull-through surgery as a method for treatment of Hirschsprung disease are infrequent. Therefore, this method can be considered as a selective method. Further investigations are recommended to prove this matte