Background: One of the major problems in pediatric surgery is anxiety and fear of separation from parents. Objectives: We studied the efficacy of different doses of oral midazolam for pre operation sedation of children. Patients and Methods:In this randomized, double-blinded clinical trial, 120 children aged 1 -8 years were enrolled in the study .The children were randomly assigned to one of 4 groups and received orally 0.5 mg/kg (group A), 0.8 mg/kg (group B), 1 mg/kg (group C), 0mg/kg (group D) of injectable midazolam mixed with 10 -15 mL apple juice 45 minutes before separation from parents. Sedation score, changes in MAP, HR, SPO2, respiratory rate, time of recovery and frequency of nightmares evaluated and analyzed with Kruskal-Wallis and ANOVA tests.

Introduction: Tonsillectomy in children is associated with some major complications originating from intense post-tonsillectomy pain which can distress patients, cause swallowing difficulties and discomfort, and also lead to aspiration. Thus, this study aimed to investigate the effect of using pre-operative ketamine injection on post-tonsillectomy pain intensity in children. Methods: This double-blind clinical trial was carried out on 60 patients undergoing elective tonsillectomy. To this end, all the patients were anaesthetized by the same method. In the first group, 2 cc of ketamine (0.5mg/kg) solution was topically injected into the soft tissue of tonsillar fossa (peritonsillar space); in the second group, a similar administration was performed but with normal saline. For all the patients, incision was made 5 minutes after injection with the Blast Dissection Snare method. Moreover, the patients’ pain intensity and analgesics consumption were measured 30 minutes, and 1, 2, 4, and 6 hours after surgery. Finally, the collected data were analyzed using the SPSS software. Results: The present study was conducted on 60 patients, 37 males and 23 females, with the mean age of 9.3±3.4 years. In this respect, repeated measures analysis of variance of patients’ pain scores collected in five post-operative stages showed that pain intensity in both groups was at the highest level immediately after operation; it gradually decreased during measurement stages. However, at each measurement, the pain intensity experienced in the ketamine-treated group was significantly lower than that for the placebo group. Conclusion: It was concluded that pre-incision topical injection of ketamine can serve as an effective method to control post-tonsillectomy throat pain.

Background & Aim: Drug abusers have much lower pain threshold, in a way that the duration of the effect of anesthesia on controlling their pain is still not fully known. Therefore, this study aimed to compare the duration of spinal anesthesia induced with bupivacaine between drug-dependent and non-dependent individuals. Methods: This quasi-experimental study was conducted on two 60-member groups consisting of drug-dependent and non-dependent patients undergoing lowerlimb orthopedic surgery. Patients were selected via simple convenience sampling and underwent a similar procedure of spinal anesthesia using the same needle and medicine by an anesthesiologist, who was unaware of the patients' placement in the study groups. After surgery, the duration of patients' anesthesia was correspondingly measured in both groups and compared using the independent t-test. Results: In this research study, no significant difference was observed between the groups in terms of age and gender. The mean duration of opium abuse in the drug-dependent patient group was reported to be 7.5+/-1.3 years. In addition, the duration of spinal anesthesia in the drug-dependent patient group was shorter, compared to the non-dependent group (P=0.0001). Conclusion: According to the results of the study, intrathecal bupivacaine is not a durable anesthesia, for performing surgeries that might last more than an hour, in drug-dependent patients.