SummaryThis study measures the anxiety levels in 100 parents of children scheduled for elective surgery at the Royal Aberdeen Children's Hospital. Anxiety levels were quantified using the Leeds scale for self-assessment of anxiety. Forty-two per cent of parents were significantly anxious. Mothers were identified as being more pathologically anxious than fathers. The 'anxious' parents were specifically more anxious about the surgery, anaesthesia, postoperative pain and treatment, and hospitalisation in general. All parents, whether identified as anxious or not, agreed on factors likely to reduce anxiety: pre-operative information from staff, being able to accompany their child to the operating theatre and being present at induction of anaesthesia.

BACKGROUND Children undergoing Tonsillectomy have significant pain. Various modalities of treatment have been used to treat pain. Our aim is to compare the duration of analgesia and comfort of child with paracetamol administered through intravenous and rectal route. MATERIALS AND METHODS 40 children undergoing tonsillectomy surgeries were randomised into two groups receiving either intravenous paracetamol (Group I) or rectal paracetamol (Group R) as suppositories. After induction and intubation, children were randomised to one of the groups. Haemodynamic parameters were recorded preop; intraop and post-operatively along with assessment of post-operative pain using Wong-Baker face pain scale for period of 10 hours. Kruskal-Wallis chi-square test was used to test the significance of difference between quantitative variables and Yate's chi square test for qualitative variables. RESULTS Thus, duration of analgesia was significantly (p= 0.0029) higher in rectal group than in IV group. Comfort scores were not statistically significant. CONCLUSION The post-operative pain scores were significantly higher in the intravenous group as compared to the rectal group. There was no difference in post-operative comfort.

Perceived risk factors vary with "experience": hiatus hernia, difficult intubation and cerebral palsy are less important whereas previous aspiration and renal failure appear to be more important for paediatric anaesthetists with less than 10 years in paediatric anaesthetic practice.

Background: Pain control for paediatric patients undergoing tonsillectomy remains problematic. Tramadol is reported to be an effective analgesic and to have a side-effect profile similar to morphine, but is currently not licensed for paediatric use in the UK. Methods: We conducted a prospective, double-blind, randomized controlled trial in children who were scheduled for elective tonsillectomy or adenotonsillectomy at the Royal Aberdeen Children Hospital. Following local ethics committee approval and after obtaining a drug exemption certificate from the Medicines Licensing Agency for an unlicensed drug, we recruited 20 patients each into morphine (0.1 mgAEkg )1 ), tramadol (1 mgAEkg )1 ) and tramadol (2 mgAEkg )1 ) groups. These drugs were given as a single injection following induction of anaesthesia. In addition, all patients received diclofenac (1 mgAEkg )1 ) rectally. The postoperative pain scores, analgesic requirements, sedation scores, signs of respiratory depression and nausea and vomiting, as well as antiemetic requirements, were noted at 4-h intervals until discharge. Results: There were no statistically significant differences in age, weight, type of operation or induction of anaesthesia, 4-h sedation and pain scores and further analgesic requirements. There were no episodes of respiratory depression. Morphine was associated with a significantly higher incidence of vomiting following discharge to the wards (75% versus 40%, P ¼ 0.03) compared with both tramadol groups.Conclusions: Tramadol has similar analgesic properties, when compared with morphine. The various pharmaceutical presentations and the availability as a noncontrolled substance may make it a useful addition to paediatric anaesthesia if it becomes licensed for paediatric anaesthesia in the UK.

We conclude that pressure controlled ventilation using an LMA is an alternative to a cuffed TT during low flow circle system anesthesia in children. Low FGF is unlikely to be achieved consistently using an uncuffed TT because of a substantial leak.