A robust closed-loop system can provide effective propofol administration during induction and maintenance of anesthesia in children. Wide variation in the calculated Ce highlights the limitation of open-loop regimes based on pharmacokinetic/pharmacodynamic models.

A double-blind, randomized multicentre study was undertaken to evaluate the possible effect of chelation treatment with ethylenediamine-tetraacetic acid (EDTA) in patients with severe intermittent claudication. A total of 153 patients received 20 intravenous infusions of either 3 g Na2EDTA or placebo during a period of 5-9 weeks. Vitamin, mineral and trace element supplements were administered orally. The changes observed in the pain-free and maximal walking distances, measured on a treadmill, were similar in the two groups. During the 3-month (n = 149) and 6-month (n = 123) follow-up period, no long-term therapeutic effect of EDTA could be demonstrated. The ankle-brachial blood pressure index remained unchanged throughout the study period. This study failed to demonstrate any effect of EDTA chelation treatment in intermittent claudication.

Purpose: To compare the analgesic effects of preoperative oral clonidine with intraoperative intravenous fentanyl in children undergoing tonsillectomy or adenotonsillectomy. Methods: This randomized, controlled, double-blind study of 36 ASA I-II children, age 7-12 yr undergoing adenotonsillectomy was conducted at a tertiary care paediatric teaching hospital. Either 4 lug'kg q clonidine p0 was given 60-90 rain preoperatively or 3/~g-kg -s fentanyl iv was given intraoperatively. Postoperatively visual analog pain scores (VAS) were recorded at rest and on swallowing every I 0 rain for the first 30 rain and then every I 5 min for two hours. Morphine 0.05 mg'kg -I iv was given for VAS _>5. If >3 doses were required, 1.5 mg.kg -I codeine p0 and 20 mg'kg q acetaminophen p0 were given. Sedation and anxiety scores were recorded preoperatively. Haemodynamic changes, blood loss, recovery scores, and the incidence of vomiting, hypotension, and airway obstruction were recorded. Results: Children who received donidine had a higher incidence of preoperative sedation (63%) than those receiving fentanyl (6%). Preinduction mean arterial pressure was lower in the clonidine group but required no intervention. VAS scores were similar throughout the observation period. There was no difference either in the number of morphine or codeine rescue doses administered or in the incidence of side effects. Conclusion: Oral clonidine is an effective analgesic and sedative for children undergoing tonsillectomy or adenotonsillectomy. Objectif : Comparer les effets analg&iques de l'administration orale de clonidine prEop&atoire et de fentanyl intraveineux perop&atoire chez des enfants devant subir une amygdalectomie ou une adEno-amygdalectomie. M~thode : Cette Etude randomisEe, contr61Ee et ~ double insu a porte sur 36 enfants ASA MI, ~gEs de 7 ~ 12 arts, devant subir une adEno-amygdalectomie dans un h6pital universitaire de soins pEdiatriques tertiaires. On a administrE 4 ug-kg "i de clonidine po 60-90 min avant l'intervention ou 3 ugkg ~ de fentanyl iv au cours de l'intervention. Les niveaux de douleur ont EtE enregistr& apt& rop&ation, ~ raide de l'EcheIle visuelle analogue (EVA), au repos et lors de la dEglutition ~ toutes les I 0 rain pendant les 30 premieres min et ~ toutes les 15 min pendant les deux heures suivantes. On a administrE 0,0S mg'kg -I de morphine iv pour des scores ~S ~ I'EVA. Si plus de 3 doses &aient n&essaires, on a donne aussi 1,5 mg-kg I de codeine po et 20 mg'kg i d'acEtaminophEne po. Avant l'intervention, on a enregistrE les niveaux de sedation et d'anxiEtE. Les changements hEmodynamiques, les pertes sanguines, les niveaux de rEcupEration et l'incidence de vomissements, d'hypotension et d'obstruction du conduit a&ien ont EtE not&. R~u]tats : Les enfants qui ont re~u de la clonidine ont pr&entE une plus grande incidence de sedation prEop&a-toire (63 %) que ceux qui ont re~u du fentanyl (6 %). Avant l'induction de l'anesth&ie, la tension art&ielle moyenne &ait plus basse dans le groupe qui avait regu de la clonidine, mais...