Background: Emergence agitation (EA) is one of the complications following anesthesia in pediatric surgery. Various drugs are used to prevent this complication, and one of them is dexmedetomidine. Choosing the right dose of this drug for the best efficiency is an important issue due to this complication.The main purpose of this study is to evaluate the prophylactic effect of intravenous dexmedetomidine in different doses in preventing EA after tonsillectomy in children. Materials and Methods: Our study was a double-blind clinical trial performed on 75 children ASAI, II candidates for tonsillectomy. Patients were divided into three groups. The group 1 received a dose of 0.6 μg/kg per hour and group 2 received a dose of 0.3 μg/kg per hour and group 3 was the control group. Then vital signs and observational pain score (OPS) and pediatric anesthesia emergence delirium (PAEDS) criteria were measured in patients. The collected data were analyzed by using SPSS software version 23 and non-parametric tests such as Friedman, Mann-Whitney. Results: According to the data analysis, mean blood pressure, mean heart rate, OPS and PAEDS score in group 1 were lower than other groups. Also, the average time of staying in recovery and extubation in group 1 was less than other groups. Conclusion: A dose of 0.6 μg/kg dexmedetomidine has a better effect on reducing EA (emergence agitation) after pediatric tonsillectomy.
Background: Due to traumatic events, patients with acetabular fractures are vulnerable to rupture of the peritoneum and abdominal hernia in the fracture site. Infection and thromboembolic events are the two most common complications of this situation. Case Report: In the current report, we present a 63 year-old woman with a traffic accident that was diagnosed with multiple fractures of posterior and anterior walls and anterior column of the right acetabulum associated with femoral head protrusion to the fracture site. Furthermore, the right posterior iliac wing fracture and mild subluxation of the right sacroiliac (SI) joint were observed in the pelvic computed tomography (CT) scan. During the Stoppa surgical approach, small intestine penetration and peritoneum were observed and immediately treated by the surgical team. Our case was later diagnosed with pulmonary thromboembolism and recovered successfully, and no infectious complications were observed. Conclusion: We suggest that bowel entrapment be considered in blunt traumatic events, and antibiotics and anti-coagulants be used in similar cases.
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