Interscalene brachial plexus block was found to be more effective than intra-articular local anesthetic injection for postoperative analgesia.

Background and Objective:Dental treatments cannot bealways performed under local anesthesia inpediatric non-cooperative patients. For this purpose, differentanesthetic techniques have been applied to increase patient comport to dental treatments.Methods:Sixty children classified as ASA I-II, between aged 3 to 9, who were scheduled to undergo tooth extraction, were enrolled for this randomized study. Group K received 1 mg/kg ketamine, Group P received 1 mg/kg propofol, and Group KP received 0.5 mg/kg propofol plus 0.5 mg/kg ketamine intravenously for anesthesia induction.Results:Recovery time was significantly lower in Group P than Group KP. No significant differences were found between groups regarding HR, before and after the induction, at tenth minute. Fifth minute’s HR was higher in Group K than Group KP. Mean arterial pressure (MAP) values were similar at baseline, before and after the induction, and at tenth minute, whereas significantly lower values were found in Group P and Group KP than in Group K at fifth minute.Conclusions:Although ketamine, propofol and ketamine-propofol combination are effective for sedation in tooth extraction in pediatric patients, propofol may be an excellent alternative, with the shortest recovery, no nausea and vomiting, and reasonable surgical satisfaction.

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Objective: To find out postoperative discomfort in children undergoing dental rehabilitation under general anesthesia (DRGA). Methods: This study involved 78 (4 to 10 year-old) healthy patients who were scheduled for DRGA and were needed extensive dental treatment because of severe caries, and showed high dental fear and/or behavioral management problems. The children had to be fit for DRGA administration by fulfilling the American Society of Anesthesiologists physical status I or II and no associated mental health or communication problems. Data were collected by structured interview either face to face (immediately post operation) or using a telephone (post operation after discharge). One of the study’s investigators recorded all data related to the immediate postoperative period during the child’s stay in the post-anesthesia care unit (PACU). The questionnaire consisted of questions related to postoperative problems experienced by the patient in the period after their day-stay attendance. The questionnaire, consisting of questions regarding and generally related to the child’s activities. In addition, pain was assessed using the face, legs, activity, cry, consolability (FLACC) scale. Results: The prevalence of postoperative problems was 46 out of 78 (59%). The mean FLACC score was 1.8 (SD=2.1). Some of the patients having more than one reported problem. Forty-one percent of the children showed nasal discomfort (P<0.01). Thirty-three percent and 43% of the children experienced throat or mouth discomfort. The most common experienced postoperative symptom after DRGA was bleeding. Nasal bleeding, however, was an uncommon complication and did not cause serious morbidity or mortality in children intubated nasotracheally. In addition, postoperative discomfort was related to number of the extractions. Children who had 4 or more extractions were more likely to experience pain. Findings associated with other bodily functions were assessed. Nausea and vomiting were reported in 20.5% of children. Twenty-six children (18%) had a fever. Thirty-nine (50.0%) parents reported that their children had problems eating. Conclusion: Post-operative discomfort was more with 4 or more extraction done under DRGA and that nasal bleeding was noted a uncommon post-operative symptom.

The effluents of wastewater treatment plants in small sized communities of less than 2000 population equivalent (PE), which are discharged into sensitive receiving water environments, must receive ''appropriate treatment'' according to the EU Urban Wastewater Treatment Directive. Appropriate treatment depends on the quality objectives of the receiving waters as well as the relevant provisions of the member states. In this study, wastewater treatment options, such as vegetated land treatment (VLT), constructed wetlands (CW), and activated sludge treatment (AST), by which effluents are discharged to sensitive and less sensitive areas are evaluated by the life cycle assessment (LCA) approach. For this purpose, data related to energy usage, land requirement, raw material consumption, and released emissions from the life phases were collected with an inventory study and the environmental impacts were assessed by using SimaPro 7.1 LCA software. The results obtained from the assessments were compared with each other, which indicated that for small-scale communities VLT and CW are the most environmentally friendly wastewater treatment option.