African journal of paediatric surgery : AJPS
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Afr J Paediatr Surg · Oct 2014
Randomized Controlled TrialPerioperative blood glucose in a paediatric daycase facility: effects of fasting and maintenance fluid.
Many Children are daily exposed to prolonged preoperative fasting time. The choice of intraoperative maintenance fluid continues to be an issue of controversy. This study assesses the duration of preoperative fast among children undergoing ambulatory surgery and the appropriateness of the maintenance solutions used. ⋯ Most children undergoing ambulatory surgery at our facility are still exposed to prolonged fasting time. Glucose containing fluid often administered as maintenance fluid to treat the presumed hypoglycaemia causes worsening hyperglycaemia, which may be harmful.
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Afr J Paediatr Surg · Apr 2014
Randomized Controlled Trial Comparative StudyComparing the analgesic effect of caudal and ilioinguinal iliohypogastric nerve blockade using bupivacaine-clonidine in inguinal surgeries in children 2-7 years old.
We compared the analgesic effects of caudal and ilioinguinal-iliohypogastric nerve block using bupivacaine-clonidine performed in children undergoing inguinal hernia repair. The ilioinguinal-iliohypogastric nerve block provides excellent pain relief for operations on the inguinal region, including emergency procedures (e.g. strangulated inguinal hernia with intestinal obstruction). It should be preferred to caudal block for these procedures. ⋯ It seems that in children, caudal epidural block and ilioinguinal - iliohypogastric nerve block using bupivacaine-clonidine have comparable effects on analgesia, severity of pain and hemodynamic changes during and after surgery on inguinal region.
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Afr J Paediatr Surg · Apr 2014
Randomized Controlled Trial Comparative StudyRisk of surgical site infection in paediatric herniotomies without any prophylactic antibiotics: A preliminary experience.
Different studies underline the use of pre-operative antibiotic prophylaxis in clean surgeries like herniotomy and inguinal orchiopexy. But, the meta-analyses do not recommend nor discard the use of prophylactic pre-operative antibiotics. The scarcity of controlled clinical trials in paediatric population further vitiates the matter. This study assessed the difference in the rate of early post-operative wound infection cases in children who received single dose of pre-operative antibiotics and children who did not receive antibiotics after inguinal herniotomy and orchiopexy. ⋯ Our preliminary experience suggests that there is no statistically significant difference in the proportion of early post-operative wound infection between the patients who received single dose of pre-operative antibiotics and the patients who received no antibiotics after inguinal herniotomy and orchiopexy. The risk of surgical site infection in paediatric heriotomies does not increase even if the child's weight is less than his/her expected weight for age.
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Afr J Paediatr Surg · Jul 2013
Randomized Controlled TrialSuccess rate of two different methods of ilioinguinal-iliohypogastric nerve block in children inguinal surgery.
The ilioinguinal-iliohypogastric (ILIH) nerve block is a safe, effective, and easy to perform in order to provide analgesia for a variety of inguinal surgical procedures in pediatric patients. A relatively high failure rate of 10%-25% has been reported, even in experienced hands. It is assumed that this high failure rate of the ILIH nerve block in this age group could be due to lack of special knowledge of the anatomy of these nerves in infants and neonates. There are two main techniques for landmark-based ILIH nerve block with regard to determining the best insertion point. This study compared the success rate and outcomes of these two techniques in children undergoing surgery in inguinal region. ⋯ Based on our findings, success rate and outcomes of the two techniques of landmark-based ILIH block are similar in children undergoing surgery in inguinal area.
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Afr J Paediatr Surg · Apr 2013
Randomized Controlled Trial Comparative StudyThe comparative study of the outcomes of early and late oral feeding in intestinal anastomosis surgeries in children.
A leakage of intestinal anastomosis is typically regarded as a devastating post-operative complication. Traditionally its believed that long fasting after intestinal surgery protect anastomosis site and most surgeons applied this method. Post-operative long fasting has many physical and mental adverse effects, especially in children, but its benefit has not proven yet. This study aimed to compare the outcomes of early and late oral feeding in intestinal resection and anastomosis surgery in children. ⋯ Early oral feeding after intestinal resection and anastomosis in children is a safe method, it has many benefits and does not increase the major or minor post-operative complications (anastomosis leakage) long time fasting is not necessary and has not any beneficial effect and early feeding increases satisfaction of the parents and children, and reduce hospital stay and costs.