Postoperative use of patient-selected music in cesarean section surgery would alleviate the pain and reduce the need for other analgesics, thus improving the recovery and early contact of mothers with their children.

Bleeding during functional endoscopic sinus surgery (FESS) remains a challenge for both surgeons and anesthesiologists despite several modalities available for improving the surgical field. This study was conducted to evaluate the effect of oral clonidine premedication on blood loss and the quality of the surgical field in FESS. In a placebo-controlled clinical trial, a total of 84 American Society of Anesthesiologists (ASA) physical status I-II patients undergoing endoscopic sinus surgery for chronic sinusitis were randomly allocated to receive either oral clonidine 0.2 mg or identical-looking placebo tablets 90 min before arrival at the operating room. Blood loss in the clonidine group was 214 ± 67 ml on average and that in the placebo group was 276 ± 78 ml (mean ± SD, p < 0.01). The median (range) bleeding score in the clonidine group was significantly lower than that in the placebo group (2 (1-3) vs. 2.5 (2-4), p < 0.0001). Accordingly, the surgeon was more satisfied with the surgical field in the clonidine group than with that in the placebo group (median score, 4 (3-5) vs. 3 (1-5), p < 0.001). In conclusion, premedication with oral clonidine 0.2 mg can effectively reduce bleeding during FESS.

Perioperative use of Strepsils tablets reduces postoperative sore throat and hoarseness of voice.

Background:One of the frequent applications of elastomeric infusion pumps is postoperative pain management. In daily practice, the disposable pumps get refilled with modified medication combinations in the successive days; although, the accuracy of infusion rates is unknown to clinicians.Objectives:Our aim was to evaluate the effect of repeated filling on the delivery rate accuracy of an elastomeric pump available in our market.Materials and Methods:We examined 10 elastomeric infusion pumps (BOT-802, Nanchang Biotek Medical Device Company, China) with 100 mL capacity and nominal flow of 5 mL/h. Each pump was filled for three times, accounting for 30 series of experiments. A microset scaled in mL was used to measure the pump deliveries. Flow profile and reliability of infusion rate were analyzed after repeated use.Results:The mean flow rate in the three series of measurements showed a gradual increase; however, the difference was not statistically significant (5.01 ± 0.07 vs. 5.03 ± 0.06 vs. 5.06 ± 0.08 mL/h; P = 0.81). The percentage of the flow rate error (deviation from 5 mL/h ± 15%) was 100% in the first and second hours of infusion, 96% in the third hour, 60% in the 20th hour and zero percent in the rest of the infusion time.Conclusions:This study indicated that the delivery rate accuracy of elastomeric infusion pumps is preserved after repeated usage. These laboratory findings suggested that elastomeric pumps could be safely refilled in the successive days to provide postoperative analgesia.

Background: Intentional lowering of blood pressure helps to produce a desirably clean surgical field. Many drugs can be used to induce a hypotensive state, but due to their high potency and rapid effect, drugs that more easily and safely control the induction of hypotension are desirable. Objectives: To investigate the effects of premedication with oral clonidine on intraoperative bleeding and hemodynamic variables in patients undergoing cesarean sections. Patients and Methods: A total of 110 patients classified as American Society of Anesthesiologists (ASA) physical status I and II and who were scheduled for elective cesarean section under general anesthesia were enrolled. The patients were randomized to receive either oral clonidine (0.2 mg) or identical-looking placebo tablets 90 minutes before arriving at the operating room. Induction of anesthesia was performed by the same standard protocol in all patients. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) and heart rate (HR) were recorded before and after induction; immediately after intubation; 5, 10, and 15 minutes thereafter; at the time of extubation; and one hour after the operation. The surgeons were asked to rate the quality of the operative field on a four-point scale that ranged from mild (1) to abundant bleeding (2). Results: Intraoperative SBP was lower in the clonidine group. After both intubation and extubation, the increases in SBP, DBP, and HR in clonidine-treated subjects were significantly less than the changes in the control patients. The amount of fentanyl given to control blood pressure and HR was significantly less in the clonidine group (18 ± 38 vs. 39 ± 53 μg, P = 0.02). The responses to the four-point scale indicated that intraoperative bleeding in the clonidine group was less than in the placebo group (1.2 ± 0.4 vs. 1.7 ± 0.6, P < 0.05). Conclusions: Premedication with oral clonidine can improve the hemodynamic management of cesarean cases.