Background:Caudal analgesia is the most commonly used technique providing intra- and postoperative analgesia for various pediatric infraumbilical surgical procedures but with the disadvantage of short duration of action after single injection. Caudal dexamethasone and magnesium could offer significant analgesic benefits. We compared the analgesic effects and side-effects of dexamethasone or magnesium added to caudal ropivacaine in pediatric patients undergoing inguinal hernia repair.Materials and Methods:A total of 105 (1-6 years) were randomly assigned into three groups in a double-blinded manner. After a standardized sevoflurane in oxygen anesthesia, each patient received a single caudal dose of ropivacaine 0.15% 1.5 mL/kg combined with either magnesium 50 mg in normal saline 1 mL (group RM), dexamethasone 0.1 mg/kg in normal saline 1 mL (group RD), or corresponding volume of normal saline (group R) according to group assignment. Postoperative analgesia, use of analgesics, and side-effects were assessed during the first 24 h.Results:Addition of magnesium or dexamethasone to caudal ropivacaine significantly prolonged analgesia duration 8 (5-11) h and 12 (8-16) h, respectively compared with 4 (3-5) h with the use of ropivacaine alone. The incidence of postoperative rescue analgesia was significantly higher in group R compared with groups RM and RD. The time to 1st analgesic dose was significantly longer in groups RM and RD (500 ± 190 and 730 ± 260 min) respectively compared with group R (260 ± 65 min). Group R patients achieved significantly higher Children's Hospital of Eastern Ontario Pain Scale and Faces Legs Activity Cry Consolability scores (4th hourly) compared with groups RM and RD patients (8th and 12th hourly, respectively).Conclusion:The addition of dexamethasone or magnesium to caudal ropivacaine significantly prolonged the duration of postoperative analgesia in children undergoing inguinal hernia repair. Also the time to 1st analgesic dose was longer and the need for rescue postoperative analgesic was reduced and without increase in incidence of side effects.
nowadays, social accessibility became a science that needs to be studied. There are many standards that are already being in place to enhance people's accessibility to web or any other application. Some of these standards as well as recommendations are already part of the new websites and new applications. The importance of the social accessibility is to provide equal opportunity for everyone to access any published materials including the disabled people. This paper is an introductory survey to the social accessibility issues, standards and tools.
Data acquisition problem on large distributed wireless sensor networks (WSNs) is considered as a challenge in the growth of Internet of Things (IoT). Recently, the combination of compressive sensing (CS) and routing techniques has attracted much attention of researchers. An open question of this combination is how to integrate these techniques effectively for specific tasks. On the other hand, CS data reconstruction process is considered as one of the CS challenges because it requires to recover N data from only M measurement where M< <N. Through this paper, we propose a new scheme for data gathering in IoT based heterogeneous WSN that includes a new effective Deterministic Clustering using CS technique (DCCS) to handle the data acquisition problem. DCCS reduces the total overhead computational cost needed to self-organize WSN using a simple approach and then uses CS at each sensor node to decrease the overall energy consumption and increase the network lifetime. The proposed scheme includes also an effective CS reconstruction algorithm called Random Selection Matching Pursuit (RSMP) to improve the recovery process at the base station (BS). RSMP adds a random selection process during the forward step to give the opportunity for more columns to be selected as an estimated solution in each iteration. The simulation results show that the proposed scheme succeeds to minimize the overall network power consumption and prolong the network lifetime beside provide better performance in CS data reconstruction.
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