A Comparative Study of Effect of Oral Melatonin Versus Oral Midazolam as Premedicant in Children Undergoing Surgery Under General Anesthesia

Background: Preoperative anxiety in children is associated with multiple post-operative outcomes like post-operative regressive behavioral disturbances, prolonged distress in the recovery phase, eating disorders, and bedwetting. The present study was designed to use low-dose oral melatonin versus oral midazolam in relieving pre-operative anxiety in children in the Indian population. Materials and Methods: A prospective randomized comparative study was conducted on children aged between 2 to 10 years of age scheduled for elective surgeries under general anesthesia are included in the study. This study was conducted with a sample size of 70. Patients were randomly distributed into two groups of 35 content. Group A (received 0.2mg/kg melatonin as premedical) and group B (received 0.5mg/kg midazolam as premedical). Results: Mean induction dose of propofol in the melatonin group was 52.143+ 18.36 mg and in the midazolam, the group was 48.714 + 16.6 mg. In our study, 90 minutes after premedication, the anxiety score was less in the midazolam group. There was no statistically significant difference between the sedation scores in melatonin and midazolam. Conclusion: Low-dose melatonin (0.2mg/kg) is not an effective alternative premedicant in children to alleviate preoperative anxiety compared to midazolam

Safety of post-operative epidural analgesia in the paediatric population: A retrospective analysis

Background and Aims: Epidural infusion analgesia (EIA) is among the common procedures performed in children to provide analgesia. However, the administration of epidural is not without complications. Limited studies are available regarding the safety of EIA in children with no studies from the Indian subcontinent. The aim of this study was to analyse all the complications that occured during administration and maintenance of EIA in paediatric patients. Methods: All children undergoing elective or emergency surgeries under general anaesthesia and given concomitant epidural analgesia for post-operative pain management were included. Data were collected by reviewing patient medical records, anaesthesia registers and post-operative intensive care unit charts. Statistical averages were drawn to assess the complication rates. Results: Seventy children received epidural analgesia during the span of study, of them five were neonates and fifteen were infants. No major complications that were life-threatening or leading to permanent disability were documented. Two children (2.85%) had blood tap during procedure. Eleven children (15%) had peri-catheter leaks and 14 children (20%) had catheter dislodgements. Conclusion: EIA seems to be a relatively safe method of providing analgesia. It is associated with the occurrence of complications which are at best temporary

Adverse Effects of Nitrous Oxide on Vitamin B12 Levels in Health Care Personnel of ESIC Tertiary Care Hospital

Background: Nitrous oxide (N2O) has a long reputation for decades as the safest general anesthetic and has a well-known function as the laughing gas. The study aimed to know the effect of nitrous oxide with chronic exposure in operation theatre (OT) personnel of the Department of Anesthesia in Sanath Nagar, Hyderabad, India. Materials and Methods: A transversal study was conducted including 88 health workers (44 exposed and 44 non-exposed). Personal exposure to nitrous oxide for the group members was assessed indirectly by measuring the years of work experience in OT. Vitamin B12 levels are measured in both groups. Data were statistically tested for normality and also qualitative, quantitative assessment was performed. Results: From the results obtained, there is no significant difference in vitamin B12 levels between exposed and non-exposed groups. There is a multiple-fold increase in other health conditions like dizziness, nausea/vomiting, euphoria, and tachycardia. Conclusion: N2O exposure in health care personnel did not show any altered vitamin B12 levels. Chronic exposure to nitrous oxide will lead to adverse health effects and it can be reduced by using an anesthesia gas scavenging system in OT