<i>Objective</i>. This randomized double-blind study compared the analgesic efficacy and tolerability of etoricoxib versus ketoprofen in 165 patients with elective total primary knee arthroplasty.<i> Methods</i>. After ethical committee approval, 165 patients were randomized in 3 groups: the etoricoxib group (E) receiving etoricoxib 120&#x2009;mg/day, at the end of surgery and in the first postoperative day; the ketoprofen group (K) receiving ketoprofen 2 pills of 100&#x2009;mg/day, the first at the end of surgery and then 1 pill every 12 hours in the surgery day and the first postoperative day; the placebo group (P). All groups received postoperatively the same analgesia protocol when NRS is over 3 with IV Perfalgan and morphine. The effectiveness was evaluated by the time from the initiation of spinal anesthesia until the first analgesic dose, the total amount of morphine administered in the surgery day and the first postoperative day, and the frequency of patients with side effects and necessary amount of adjuvant medication.<i> Results</i>. The baseline demographic characteristics were similar among the 3 groups. In both study days etoricoxib provided an analgesic effect superior to placebo and to ketoprofen, the total administered morphine being significantly lower in etoricoxib group. There were no statistically significant differences between groups regarding the side effects.

Simona Cionac Florescu

Denisa Madalina Anastase

Ana Maria Munteanu

Cristian Ioan Stoica

Postoperative Etoricoxib versus Ketoprofen Administration for Pain Management after Total Knee Arthroplasty: A Randomized, Double-Blind Controlled Study

<i>Introduction</i>. We explored how ethnicity affects the risk of postoperative nausea and vomiting (PONV) and established the correlation of suggested risk factors of PONV in the multiethnic population of Singapore.<i> Methods</i>. 785 patients who underwent orthopaedic surgery were recruited. These comprised 619 Chinese (78.9%), 76 Malay (9.7%), 68 Indian (8.7%), and 22 other (2.8%) cases. The presence of possible risk factors of PONV and nausea and/or vomiting within 24 h after surgery was studied. Univariate and multivariate logistic regression analyses were performed.<i> Results</i>. The incidence of PONV was 33.2% (261 patients). There was no statistically significant difference of PONV incidence between Chinese, Malay, and Indian cases (34.6% versus 34.2% versus 29.4%, <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-3.32502pt" id="M1" height="11.6608pt" version="1.1" viewBox="-0.0498162 -8.33578 51.7247 11.6608" width="51.7247pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g50-113" d="M573 302C573 402 527 451 414 451C386 451 343 446 313 437L330 513L320 522C295 508 261 484 243 463L230 415C194 400 159 383 126 359L131 330C159 344 187 357 222 368L109 -147C96 -204 80 -214 18 -223L13 -255L256 -244L259 -212L236 -210C184 -205 180 -195 191 -141L219 -1C240 -10 268 -12 284 -12C352 4 431 48 484 104C543 166 573 240 573 302ZM481 290C481 165 381 37 305 37C280 37 249 56 235 71L302 395C328 399 353 402 372 402C427 402 481 378 481 290Z"/></g><g transform="matrix(.013,0,0,-0.013,11.438,0)"><path id="g54-34" d="M556 331V384H55V331H556ZM556 140V193H55V140H556Z"/></g><g transform="matrix(.013,0,0,-0.013,23.056,0)"><path id="g50-49" d="M245 635C92 635 37 457 37 312C37 149 91 -12 244 -12C395 -12 449 166 449 312C449 469 395 635 245 635ZM243 598C332 598 358 454 358 312C358 173 334 26 245 26C158 26 128 174 128 313S152 598 243 598Z"/></g><g transform="matrix(.013,0,0,-0.013,29.387,0)"><path id="g50-47" d="M117 -12C153 -12 178 12 178 50C178 84 153 110 118 110C84 110 59 84 59 50C59 12 84 -12 117 -12Z"/></g><g transform="matrix(.013,0,0,-0.013,32.468,0)"><path id="g50-55" d="M141 347C171 480 264 541 327 570C364 587 403 599 436 605L429 641C389 634 339 622 300 609C191 570 37 458 37 239C37 86 126 -12 245 -12C367 -12 454 89 454 210C454 314 380 397 272 397C252 397 230 390 208 380L141 347ZM231 338C323 338 366 257 366 174C366 108 340 27 263 27C180 27 129 123 129 244C129 268 130 292 135 310C158 323 193 338 231 338Z"/></g><g transform="matrix(.013,0,0,-0.013,38.799,0)"><path id="g50-58" d="M247 635C116 635 39 518 39 421C39 315 113 237 221 237C239 237 258 241 281 253L349 289C315 140 204 42 60 19L66 -15C90 -15 153 -5 207 16C344 70 447 199 447 385C447 521 373 635 247 635ZM231 598C329 598 356 478 356 390C356 371 355 347 352 325C330 309 297 297 262 297C179 297 127 369 127 456C127 515 156 598 231 598Z"/></g><g transform="matrix(.013,0,0,-0.013,45.131,0)"><path id="g50-54" d="M158 548H390L417 615L410 623H122L83 318C105 326 143 337 185 337C296 337 350 275 350 188C350 116 308 42 225 42C164 42 122 74 100 93C90 101 82 99 72 92C60 82 51 68 50 59C48 46 52 38 66 24C82 9 125 -12 172 -12C225 -11 292 15 346 59C408 108 437 166 437 226C437 309 371 397 242 397C214 397 170 382 133 369L158 548Z"/></g></svg>). Indian females younger than 50 years were found to have a higher incidence of vomiting (<svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-3.32502pt" id="M2" height="11.6608pt" version="1.1" viewBox="-0.0498162 -8.33578 45.37 11.6608" width="45.37pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g50-113"/></g><g transform="matrix(.013,0,0,-0.013,11.438,0)"><use xlink:href="#g54-34"/></g><g transform="matrix(.013,0,0,-0.013,23.056,0)"><use xlink:href="#g50-49"/></g><g transform="matrix(.013,0,0,-0.013,29.387,0)"><use xlink:href="#g50-47"/></g><g transform="matrix(.013,0,0,-0.013,32.468,0)"><use xlink:href="#g50-49"/></g><g transform="matrix(.013,0,0,-0.013,38.799,0)"><path id="g50-51" d="M414 144C384 79 371 75 317 75H135L276 221C367 316 408 376 408 465C408 570 327 635 237 635C179 635 131 609 100 575L42 494L67 471C94 510 138 565 205 565C277 565 321 517 321 435C321 348 258 270 195 195C146 137 88 81 33 26V0H411C423 44 433 88 446 135L414 144Z"/></g></svg>). The significant risk factors for this population include females, use of nitrous oxide, and a history of PONV.<i> Conclusion</i>. In the groups studied, ethnicity is not a significant risk factor for PONV except for young Indian females who have a higher risk of postoperative vomiting. We suggest the selective usage of antiemetic for young Indian females as prophylaxis and avoiding nitrous oxide use in high-risk patients. 

Xin Yu Adeline Leong

Xian Wen Charlene Kwa

Shu Hui Elizabeth Ng

Liang Khai Darren Koh

Singapore General Hospital Experience on Ethnicity and the Incidence of Postoperative Nausea and Vomiting after Elective Orthopaedic Surgeries

<i>Background</i>. Video laryngoscopes provide better view and can improve ease of intubation compared with standard laryngoscopes.<i> Methods</i>. A prospective randomized study was done on 60 patients, 18 to 65 years old, comparing McGrath video laryngoscope and Macintosh laryngoscope. The aim was to compare the ease, efficacy, and usability of them during routine airway management. The primary endpoint was duration of intubation and the secondary endpoints were Cormack and Lehane grade of laryngoscopic view, number of intubation attempts, and incidence of complications.<i> Results</i>. There was an increase in total duration of intubation with McGrath video laryngoscope with 42.9 &#xb1; 19.5 seconds compared to Macintosh laryngoscope with 17.9 &#xb1; 4.6 seconds. In Macintosh group, 73.3&#x25; had grade I, 20&#x25; had grade II, and 6.7&#x25; had grade III Cormack Lehane view, while in McGrath group, 83.3&#x25; had grade I, 13.3&#x25; had grade II, and 3.3&#x25; had grade III. In McGrath group, 6 patients (20&#x25;) required more than 120 seconds to get intubated and only 73.3&#x25; were intubated in 1 attempt, while patients in Macintosh group had 100&#x25; successful intubation in 1 attempt. Pharyngeal trauma was seen with McGrath videolaryngoscopy.<i> Conclusion</i>. Duration of laryngoscopy, intubation, and total duration of intubation were significantly higher in McGrath group than in Macintosh group. McGrath group required a higher number of intubation attempts.

Prerana N. Shah

Kaveri Das

McGrath Video Laryngoscope May Take a Longer Intubation Time Than Macintosh Laryngoscope

<i  >Background/Aim</i>. Intrathecal anaesthesia has been shown to increase sedation level. This study aimed to evaluate the effects of intrathecal applied fentanyl with levobupivacaine on intraoperative sedation and recovery room delirium.<i  > Materials and Methods</i>. The study included 68 patients, ASA I&#x2013;III, 55&#x2013;85 years. One day preoperatively, the Confusion Assessment Method (CAM) and the Mini Mental Status Test (MMST) were applied and patients were separated into two groups. In Group L 2.5&#x2009;mL levobupivacaine and in Group LF 2&#x2009;mL levobupivacaine and 0.5&#x2009;mL fentanyl were applied intrathecally. In a supine position, following a propofol IV 1&#x2009;mg&#x2009;kg<sup  >&#x2212;1</sup> bolus to obtain Bispectral Index (BIS) of 70&#x2013;85, propofol infusion was started (1&#x2009;mg kg<sup  >&#x2212;1</sup>&#x2009;st<sup  >&#x2212;1</sup>). With observation of SpO<sub  >2</sub>, BIS, and the Observer Assessment and Alertness/Sedation Scale (OAA/SS) with the haemodynamic values, the total propofol amount was calculated. Evaluations were made of pain severity (VAS), analgesic use, transfusion requirement, and recovery room delirium.<i  > Results</i>. In the comparison within the groups, a significant decrease was determined in HR and MAP compared to the initial values (<svg  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg"   style="vertical-align:-3.32502pt" id="M1" height="11.6608pt" version="1.1" viewBox="-0.0498162 -8.33578 45.37 11.6608" width="45.37pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g50-113" d="M573 302C573 402 527 451 414 451C386 451 343 446 313 437L330 513L320 522C295 508 261 484 243 463L230 415C194 400 159 383 126 359L131 330C159 344 187 357 222 368L109 -147C96 -204 80 -214 18 -223L13 -255L256 -244L259 -212L236 -210C184 -205 180 -195 191 -141L219 -1C240 -10 268 -12 284 -12C352 4 431 48 484 104C543 166 573 240 573 302ZM481 290C481 165 381 37 305 37C280 37 249 56 235 71L302 395C328 399 353 402 372 402C427 402 481 378 481 290Z" /><glyph.data ascent="3443" descent="-2856" horiz-adv-x="597" vert-adv-y="597" /></g><g transform="matrix(.013,0,0,-0.013,11.438,0)"><path id="g54-91" d="M530 -6V57L144 261V263L530 468V530L81 290V234L530 -6Z" /><glyph.data ascent="3443" descent="-2856" horiz-adv-x="611" vert-adv-y="611" /></g><g transform="matrix(.013,0,0,-0.013,23.056,0)"><path id="g50-49" d="M245 635C92 635 37 457 37 312C37 149 91 -12 244 -12C395 -12 449 166 449 312C449 469 395 635 245 635ZM243 598C332 598 358 454 358 312C358 173 334 26 245 26C158 26 128 174 128 313S152 598 243 598Z" /><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487" /></g><g transform="matrix(.013,0,0,-0.013,29.387,0)"><path id="g50-47" d="M117 -12C153 -12 178 12 178 50C178 84 153 110 118 110C84 110 59 84 59 50C59 12 84 -12 117 -12Z" /><glyph.data ascent="3443" descent="-2856" horiz-adv-x="237" vert-adv-y="237" /></g><g transform="matrix(.013,0,0,-0.013,32.468,0)"><path id="g50-49" d="M245 635C92 635 37 457 37 312C37 149 91 -12 244 -12C395 -12 449 166 449 312C449 469 395 635 245 635ZM243 598C332 598 358 454 358 312C358 173 334 26 245 26C158 26 128 174 128 313S152 598 243 598Z" /><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487" /></g><g transform="matrix(.013,0,0,-0.013,38.799,0)"><path id="g50-54" d="M158 548H390L417 615L410 623H122L83 318C105 326 143 337 185 337C296 337 350 275 350 188C350 116 308 42 225 42C164 42 122 74 100 93C90 101 82 99 72 92C60 82 51 68 50 59C48 46 52 38 66 24C82 9 125 -12 172 -12C225 -11 292 15 346 59C408 108 437 166 437 226C437 309 371 397 242 397C214 397 170 382 133 369L158 548Z" /><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487" /></g></svg>). A positive correlation was found between the BIS and OAA/SS values. The amounts of propofol used were similar between the groups.<i  > Conclusions</i>. Intrathecal fentanyl and levobupivacaine had the same effect on sedation or BIS and fentanyl did not cause delirium.

Ozgur Bulent Tuzun

Nurten Bakan

Mehtap Ozdemir

Yonca Yanli

Nuran Akinci Ekinci

The Effects of Intrathecal Fentanyl on Sedation Depth and Postoperative Recovery Room Delirium

This randomized trial was conducted to assess the efficacy and recovery profile of low dose intravenous dexmedetomidine in prevention of post-sevoflurane emergence delirium in children undergoing cataract surgery. Sixty-three children aged 1&#x2013;6 years were included. Anesthesia was induced with sevoflurane and airway was maintained with LMA. They were randomized to group D 0.15 (received intravenous dexmedetomidine 0.15&#x2009;<i  >&#x3bc;</i>g/kg), group D 0.3 (received dexmedetomidine 0.3&#x2009;<i  >&#x3bc;</i>g/kg), or group NS (received normal saline). The incidence of emergence delirium, intraoperative haemodynamic variables, Aldrete scoring, pain scoring, rescue medication, and discharge time were recorded. Emergence delirium was significantly reduced in dexmedetomidine treated groups with incidence being 10&#x25; in group D 0.15, none in group D 0.3, and 35&#x25; in the NS group (<svg  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg"   style="vertical-align:-3.42938pt" id="M1" height="11.7782pt" version="1.1" viewBox="-0.0498162 -8.34882 50.7895 11.7782" width="50.7895pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-113" d="M570 304C570 398 525 448 414 448C385 448 343 445 312 434L329 511L321 518C297 504 262 482 244 460L233 411C195 397 159 381 128 358L135 332C160 347 189 360 224 373L111 -147C97 -210 84 -218 17 -231L13 -257L254 -247L259 -218L233 -216C183 -212 177 -202 189 -142L218 -1C238 -10 266 -12 283 -12C351 3 429 48 483 105C543 168 570 242 570 304ZM482 289C482 161 380 33 304 33C278 33 248 51 233 69L303 396C326 400 352 403 369 403C428 403 482 380 482 289Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="593" vert-adv-y="593" /></g><g transform="matrix(.013,0,0,-0.013,11.342,0)"><path id="g117-34" d="M535 323V373H52V323H535ZM535 138V188H52V138H535Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="587" vert-adv-y="587" /></g><g transform="matrix(.013,0,0,-0.013,22.605,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" /></g><g transform="matrix(.013,0,0,-0.013,28.845,0)"><path id="g113-47" d="M113 -12C146 -12 170 11 170 46C170 78 146 103 114 103S58 78 58 46C58 11 82 -12 113 -12Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="228" vert-adv-y="228" /></g><g transform="matrix(.013,0,0,-0.013,31.809,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" /></g><g transform="matrix(.013,0,0,-0.013,38.049,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" /></g><g transform="matrix(.013,0,0,-0.013,44.289,0)"><path id="g113-51" d="M412 140C382 77 369 73 315 73H129L270 222C362 320 402 379 402 466C402 571 322 635 234 635C177 635 130 609 99 576L42 495L64 475C90 514 133 568 201 568C274 568 318 519 318 435C318 349 255 267 193 193C144 135 87 78 32 23V0H405C417 45 427 89 440 131L412 140Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" /></g></svg>). Significantly lower PAED scores were observed in D 0.15 and D 0.3 group compared to the NS group (<svg  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg"   style="vertical-align:-3.42938pt" id="M2" height="11.7782pt" version="1.1" viewBox="-0.0498162 -8.34882 50.7895 11.7782" width="50.7895pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-113" d="M570 304C570 398 525 448 414 448C385 448 343 445 312 434L329 511L321 518C297 504 262 482 244 460L233 411C195 397 159 381 128 358L135 332C160 347 189 360 224 373L111 -147C97 -210 84 -218 17 -231L13 -257L254 -247L259 -218L233 -216C183 -212 177 -202 189 -142L218 -1C238 -10 266 -12 283 -12C351 3 429 48 483 105C543 168 570 242 570 304ZM482 289C482 161 380 33 304 33C278 33 248 51 233 69L303 396C326 400 352 403 369 403C428 403 482 380 482 289Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="593" vert-adv-y="593" /></g><g transform="matrix(.013,0,0,-0.013,11.342,0)"><path id="g117-34" d="M535 323V373H52V323H535ZM535 138V188H52V138H535Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="587" vert-adv-y="587" /></g><g transform="matrix(.013,0,0,-0.013,22.605,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" /></g><g transform="matrix(.013,0,0,-0.013,28.845,0)"><path id="g113-47" d="M113 -12C146 -12 170 11 170 46C170 78 146 103 114 103S58 78 58 46C58 11 82 -12 113 -12Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="228" vert-adv-y="228" /></g><g transform="matrix(.013,0,0,-0.013,31.809,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" /></g><g transform="matrix(.013,0,0,-0.013,38.049,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" /></g><g transform="matrix(.013,0,0,-0.013,44.289,0)"><path id="g113-53" d="M456 178V225H360V632H320C217 496 115 347 20 206V178H280V106C280 40 276 34 189 27V0H445V27C364 34 360 39 360 106V178H456ZM280 225H82C149 335 214 431 278 520H280V225Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" /></g></svg>). Discharge time was significantly prolonged in the NS group compared to D 0.15 and D 0.3 (45.1&#x2009;min &#xb1; 4.4 versus 36.8&#x2009;min &#xb1; 3.8 versus 34.4&#x2009;min &#xb1; 4.6), <svg  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg"   style="vertical-align:-3.42938pt" id="M3" height="11.7782pt" version="1.1" viewBox="-0.0498162 -8.34882 44.5261 11.7782" width="44.5261pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-113" d="M570 304C570 398 525 448 414 448C385 448 343 445 312 434L329 511L321 518C297 504 262 482 244 460L233 411C195 397 159 381 128 358L135 332C160 347 189 360 224 373L111 -147C97 -210 84 -218 17 -231L13 -257L254 -247L259 -218L233 -216C183 -212 177 -202 189 -142L218 -1C238 -10 266 -12 283 -12C351 3 429 48 483 105C543 168 570 242 570 304ZM482 289C482 161 380 33 304 33C278 33 248 51 233 69L303 396C326 400 352 403 369 403C428 403 482 380 482 289Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="593" vert-adv-y="593" /></g><g transform="matrix(.013,0,0,-0.013,11.342,0)"><path id="g117-91" d="M512 -3V55L134 254V256L512 456V514L75 281V230L512 -3Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="587" vert-adv-y="587" /></g><g transform="matrix(.013,0,0,-0.013,22.605,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" /></g><g transform="matrix(.013,0,0,-0.013,28.845,0)"><path id="g113-47" d="M113 -12C146 -12 170 11 170 46C170 78 146 103 114 103S58 78 58 46C58 11 82 -12 113 -12Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="228" vert-adv-y="228" /></g><g transform="matrix(.013,0,0,-0.013,31.809,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" /></g><g transform="matrix(.013,0,0,-0.013,38.049,0)"><path id="g113-51" d="M412 140C382 77 369 73 315 73H129L270 222C362 320 402 379 402 466C402 571 322 635 234 635C177 635 130 609 99 576L42 495L64 475C90 514 133 568 201 568C274 568 318 519 318 435C318 349 255 267 193 193C144 135 87 78 32 23V0H405C417 45 427 89 440 131L412 140Z" /><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" /></g></svg>. Intravenous dexmedetomidine in low doses (0.3 and 0.15&#x2009;<i  >&#x3bc;</i>g/kg) was found to be effective in reducing emergence delirium in children undergoing unilateral cataract surgery.

Babita Ghai

Divya Jain

Payal Coutinho

Jyotsna Wig

Effect of Low Dose Dexmedetomidine on Emergence Delirium and Recovery Profile following Sevoflurane Induction in Pediatric Cataract Surgeries

<i>Objective</i>. The aim of this study was to evaluate the arterial to end-tidal partial pressure gradient of carbon dioxide according to age in the supine position during general anesthesia. <i>Methods</i>. From January 2001 to December 2013, we evaluated 596 patients aged &#x2265;16 years who underwent general anesthesia in the supine position. The anesthetic charts of these 596 patients, all classified as American Society of Anesthesiologists physical status I or II, were retrospectively reviewed to investigate the accuracy of PaCO<sub>2</sub> and ETCO<sub>2</sub>. <i>Results</i>. The a-ETCO<sub>2</sub> was <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.3625803pt" id="M1" height="9.06134pt" version="1.1" viewBox="-0.0498162 -8.69876 50.9914 9.06134" width="50.9914pt"><g transform="matrix(.0135,0,0,-0.0135,0,0)"><path id="g113-52" d="M285 378C315 398 338 416 353 432C373 451 384 474 384 503C384 579 325 635 236 635H235C182 635 136 610 108 579L65 516L85 496C110 533 150 575 205 575C258 575 300 543 300 481C300 407 232 369 141 339L147 310C163 315 188 321 211 321C268 321 338 284 338 192C338 94 288 40 217 40C160 40 119 68 93 91C85 98 77 97 69 91C60 84 47 71 46 58C44 46 48 35 62 22C75 10 116 -12 162 -12C234 -12 424 62 424 224C424 297 373 359 285 376V378Z"/></g><g transform="matrix(.0135,0,0,-0.0135,6.503,0)"><path id="g113-47" d="M113 -12C146 -12 170 11 170 46C170 78 146 103 114 103S58 78 58 46C58 11 82 -12 113 -12Z"/></g><g transform="matrix(.0135,0,0,-0.0135,9.592,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z"/></g><g transform="matrix(.0135,0,0,-0.0135,21.394,0)"><path id="g117-37" d="M535 290V340H323V533H265V340H52V290H265V84H323V290H535ZM535 -22V28H52V-22H535Z"/></g><g transform="matrix(.0135,0,0,-0.0135,34.646,0)"><path id="g113-51" d="M412 140C382 77 369 73 315 73H129L270 222C362 320 402 379 402 466C402 571 322 635 234 635C177 635 130 609 99 576L42 495L64 475C90 514 133 568 201 568C274 568 318 519 318 435C318 349 255 267 193 193C144 135 87 78 32 23V0H405C417 45 427 89 440 131L412 140Z"/></g><g transform="matrix(.0135,0,0,-0.0135,41.149,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.0135,0,0,-0.0135,44.238,0)"><path id="g113-50" d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z"/></g></svg>&#x2009;mmHg for patients aged 16 to &#x3c;65 years and <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.3625803pt" id="M2" height="9.06134pt" version="1.1" viewBox="-0.0498162 -8.69876 46.4494 9.06134" width="46.4494pt"><g transform="matrix(.0135,0,0,-0.0135,0,0)"><path id="g113-53" d="M456 178V225H360V632H320C217 496 115 347 20 206V178H280V106C280 40 276 34 189 27V0H445V27C364 34 360 39 360 106V178H456ZM280 225H82C149 335 214 431 278 520H280V225Z"/></g><g transform="matrix(.0135,0,0,-0.0135,6.503,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.0135,0,0,-0.0135,9.592,0)"><use xlink:href="#g113-50"/></g><g transform="matrix(.0135,0,0,-0.0135,19.124,0)"><use xlink:href="#g117-37"/></g><g transform="matrix(.0135,0,0,-0.0135,30.104,0)"><use xlink:href="#g113-52"/></g><g transform="matrix(.0135,0,0,-0.0135,36.608,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.0135,0,0,-0.0135,39.697,0)"><use xlink:href="#g113-50"/></g></svg>&#x2009;mmHg for patients &#x2265;65 years. The a-ETCO<sub>2</sub> was <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.3625803pt" id="M3" height="9.06134pt" version="1.1" viewBox="-0.0498162 -8.69876 46.4494 9.06134" width="46.4494pt"><g transform="matrix(.0135,0,0,-0.0135,0,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.0135,0,0,-0.0135,6.503,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.0135,0,0,-0.0135,9.592,0)"><use xlink:href="#g113-53"/></g><g transform="matrix(.0135,0,0,-0.0135,19.124,0)"><use xlink:href="#g117-37"/></g><g transform="matrix(.0135,0,0,-0.0135,30.104,0)"><use xlink:href="#g113-52"/></g><g transform="matrix(.0135,0,0,-0.0135,36.608,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.0135,0,0,-0.0135,39.697,0)"><use xlink:href="#g113-50"/></g></svg>&#x2009;mmHg for patients aged 16 to 25 years, <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.3625803pt" id="M4" height="9.06134pt" version="1.1" viewBox="-0.0498162 -8.69876 46.4494 9.06134" width="46.4494pt"><g transform="matrix(.0135,0,0,-0.0135,0,0)"><use xlink:href="#g113-52"/></g><g transform="matrix(.0135,0,0,-0.0135,6.503,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.0135,0,0,-0.0135,9.592,0)"><use xlink:href="#g113-50"/></g><g transform="matrix(.0135,0,0,-0.0135,19.124,0)"><use xlink:href="#g117-37"/></g><g transform="matrix(.0135,0,0,-0.0135,30.104,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.0135,0,0,-0.0135,36.607,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.0135,0,0,-0.0135,39.696,0)"><use xlink:href="#g113-51"/></g></svg>&#x2009;mmHg for patients aged 26 to 35 years, <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.3625803pt" id="M5" height="9.06134pt" version="1.1" viewBox="-0.0498162 -8.69876 46.4494 9.06134" width="46.4494pt"><g transform="matrix(.0135,0,0,-0.0135,0,0)"><use xlink:href="#g113-52"/></g><g transform="matrix(.0135,0,0,-0.0135,6.503,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.0135,0,0,-0.0135,9.592,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.0135,0,0,-0.0135,19.124,0)"><use xlink:href="#g117-37"/></g><g transform="matrix(.0135,0,0,-0.0135,30.104,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.0135,0,0,-0.0135,36.607,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.0135,0,0,-0.0135,39.696,0)"><use xlink:href="#g113-51"/></g></svg>&#x2009;mmHg for patients aged 36 to 45 years, <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.3625803pt" id="M6" height="9.06134pt" version="1.1" viewBox="-0.0498162 -8.69876 46.4494 9.06134" width="46.4494pt"><g transform="matrix(.0135,0,0,-0.0135,0,0)"><use xlink:href="#g113-52"/></g><g transform="matrix(.0135,0,0,-0.0135,6.503,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.0135,0,0,-0.0135,9.592,0)"><use xlink:href="#g113-53"/></g><g transform="matrix(.0135,0,0,-0.0135,19.124,0)"><use xlink:href="#g117-37"/></g><g transform="matrix(.0135,0,0,-0.0135,30.105,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.0135,0,0,-0.0135,36.608,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.0135,0,0,-0.0135,39.697,0)"><use xlink:href="#g113-49"/></g></svg>&#x2009;mmHg for patients aged 46 to 55 years, <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.3625803pt" id="M7" height="9.06134pt" version="1.1" viewBox="-0.0498162 -8.69876 46.4494 9.06134" width="46.4494pt"><g transform="matrix(.0135,0,0,-0.0135,0,0)"><use xlink:href="#g113-52"/></g><g transform="matrix(.0135,0,0,-0.0135,6.503,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.0135,0,0,-0.0135,9.592,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.0135,0,0,-0.0135,19.124,0)"><use xlink:href="#g117-37"/></g><g transform="matrix(.0135,0,0,-0.0135,30.104,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.0135,0,0,-0.0135,36.607,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.0135,0,0,-0.0135,39.696,0)"><use xlink:href="#g113-49"/></g></svg>&#x2009;mmHg for patients aged 56 to 64 years, <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.3625803pt" id="M8" height="9.06134pt" version="1.1" viewBox="-0.0498162 -8.69876 46.4494 9.06134" width="46.4494pt"><g transform="matrix(.0135,0,0,-0.0135,0,0)"><use xlink:href="#g113-53"/></g><g transform="matrix(.0135,0,0,-0.0135,6.503,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.0135,0,0,-0.0135,9.592,0)"><use xlink:href="#g113-52"/></g><g transform="matrix(.0135,0,0,-0.0135,19.124,0)"><use xlink:href="#g117-37"/></g><g transform="matrix(.0135,0,0,-0.0135,30.105,0)"><use xlink:href="#g113-52"/></g><g transform="matrix(.0135,0,0,-0.0135,36.608,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.0135,0,0,-0.0135,39.697,0)"><use xlink:href="#g113-51"/></g></svg>&#x2009;mmHg for patients aged 65 to 74 years, and <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.3625803pt" id="M9" height="9.06134pt" version="1.1" viewBox="-0.0498162 -8.69876 46.4494 9.06134" width="46.4494pt"><g transform="matrix(.0135,0,0,-0.0135,0,0)"><use xlink:href="#g113-52"/></g><g transform="matrix(.0135,0,0,-0.0135,6.503,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.0135,0,0,-0.0135,9.592,0)"><path id="g113-56" d="M447 623H65C61 580 56 530 47 475H76C100 541 106 550 172 550H388C308 376 196 170 91 -1L98 -12L172 -2C268 204 360 408 455 611L447 623Z"/></g><g transform="matrix(.0135,0,0,-0.0135,19.126,0)"><use xlink:href="#g117-37"/></g><g transform="matrix(.0135,0,0,-0.0135,30.107,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.0135,0,0,-0.0135,36.61,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.0135,0,0,-0.0135,39.699,0)"><path id="g113-57" d="M249 635C141 635 70 555 70 471C70 401 114 353 179 316C143 294 106 267 90 252C68 231 45 202 45 157C45 50 130 -12 237 -12C322 -12 435 52 435 169C435 256 372 304 303 343C349 374 375 398 383 407C401 429 411 458 411 487C411 569 344 635 249 635ZM238 603C285 603 337 567 337 482C337 422 310 385 276 358C205 393 145 426 145 500C145 552 179 603 238 603ZM248 20C183 20 125 70 125 163C125 218 158 268 206 300C284 261 355 217 355 143C355 66 308 20 248 20Z"/></g></svg>&#x2009;mmHg for patients aged 75 to 84 years. <i>Conclusion</i>. The arterial to end-tidal partial pressure gradient of carbon dioxide tended to increase with increasing age.

Kenichi Satoh

Ayako Ohashi

Miho Kumagai

Masahito Sato

Akiyoshi Kuji

Shigeharu Joh

Evaluation of Differences between PaCO<sub>2</sub> and ETCO<sub>2</sub> by Age as Measured during General Anesthesia with Patients in a Supine Position

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Journal of Anesthesiology