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Purpose:The purpose of our study was to research the effect of paracetamol as a commonly used analgesic, on pain when administered as 30 mg/kg i.v. intra-operative dose to children who underwent tonsillectomy and adenotonsillectomy, during the post-operative period. Materials and Methods:The study included 28 children between 6 and 12 years of age and ASA classification I and II, who were scheduled for tonsillectomy or adenotonsillectomy. Patients who were administered NSAIDs within 8 hours, any analgesics within 12 hours and corticosteroids during the last 7 days pre-op were excluded from the study. No narcotic analgesics were used as pre-medication and peroperatively on the subjects. Anesthesia was induced by Thiopental 5 mg/kg i.v. and muscle paralysis by Rocuronium 0.1 mg/kg i.v. Anesthetic permanence was achieved by Sevoflurane 1-2 % and N 2 O/O 2 50 %/50 %. The subjects were randomized in two separate groups. Group P was administered (Paracetamol, n=14) paracetamol 30 mg/kg i.v. and Group S (Saline, n=14) was administered saline infusion in equivalent volume at minute 15 peroperatively. The nausea-vomit frequency was recorded post-operatively at 15 minute intervals using post-op nauseavomit scoring while the pain score was recorded using the 7 point facial expression scale.Results: No significant difference was found in the postoperative nausea and vomiting frequency between the groups. However, the post-operative pain score of the paracetamol group was found higher than the control group in postextubation, 15 th min and 30 th min periods.Conclusion: Paracetamol administered through the i.v. route was found to reduce pain in children who underwent tonsillectomy and adenotonsillectomy during the early post-operative period. ÖZET Adenotonsillektomi yapılan çocuklarda intraoperatif parasetamolün postoperatif bulantı-kusma ve ağrıya etkisiAmaç: Çalışmamızda amaç, yaygın olarak kullanılan bir analjezik olan parasetamolün, tonsillektomi ve adenotonsillektomi uygulanan çocuklarda intraoperatif 30 mg/kg i.v. dozunda uygulandığında postoperatif dönemde ağrı üzerine etkisinin araştırılmasıdır. Gereç ve Yöntem: Tonsillektomi veya adenotonsillektomi ameliyatı olacak, yaşları 6-12 arasında, ASA sınıflaması I ve II olan 28 çocuk çalışma kapsamına alındı. Preop son 8 saat içinde NSAİİ, son 12 saat içinde herhangi bir analjezik ilaç ve son 7 gün içinde kortikosteroid kullanmış olan hastalar çalışmaya dahil edilmedi. Tüm olgulara premedikasyonda ve peroperatif narkotik analjezik kullanılmadı. Anestezi indüksiyonu tiyopental 5 mg/kg i.v. ve kas paralizisi rokuronyum 0.1 mg/kg i.v. ile sağlandı. Anestezi idamesi sevofluran % 1-2 ve N 2 O/O 2 % 50/% 50 ile sağlandı. Olgular rastgele iki gruba ayrıldı. Grup P'ye (Parasetamol, n=14) parasetamol 30 mg/kg i.v.; Grup S'ye (Serum fizyolojik, n=14) eşdeğer volümde serum fizyolojik infüzyonu peroperatif 15 dk.'da uygulandı. Postoperatif 15 dk. arayla bulantı-kusma sıklığı ve 7 puanlı yüz ifadesi skalası kullanılarak ağrı skoru kaydedildi. Bulgular: Gruplar arasında postoperatif bulant...

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Previous studies have shown that low-dose and long-term corticosteroid therapy is associated with good clinical outcomes in patients with acute respiratory distress syndrome (ARDS). However, there is no study investigating the efficacy of corticosteroids in these patients according to ARDS types. The aim of our study is to compare the clinical parameters and in-hospital outcomes of pulmonary and extrapulmonary ARDS patients who were treated with corticosteroids in addition to conventional treatments. The data of 22 patients, who were followed up in intensive care unit, diagnosed as ARDS and underwent low-dose and long-term methylprednisolone treatment between January 2008 and December 2012 were retrospectively investigated. Patients were divided into two main groups as pulmonary ARDS (14 patients) and extrapulmonary ARDS (8 patients), and comparisons were made. There was no significant difference between pulmonary ARDS and extrapulmonary ARDS groups in terms of age, gender, weight, length of stay in intensive care unit, onset day of ARDS development, and duration of mechanical ventilation (MV). However, the weaning from MV and in-hospital survival rate was significantly lower in extrapulmonary ARDS group. In multivariate analysis, extrapulmonary ARDS was detected as an independent predictor of in-hospital mortality. In conclusion, although previous studies have shown an increased survival rate in ARDS patients who received methylprednisolone therapy, in our study it was found that survival rate was lower in extrapulmonary ARDS compared to pulmonary ARDS. Therefore, it is concluded that more detailed studies are required to demonstrate the benefit of corticosteroids in the treatment of extrapulmonary cases of ARDS.