A study of intubating conditions: Sevoflurane versus propofol-suxamethonium in children.

BACKGROUND: Endotracheal intubation is an integral part of general anaesthesia in children, and the choice of induction agents and technique may affect the ease of intubation and thus the outcome of paediatric patients. We compared the ease of endotracheal intubation following sevoflurane and propofol-suxamethonium induction using Helbo-Hansen score. PATIENTS AND METHODS: A prospective, randomized double-blinded comparative study conducted on sixty-six children (two groups of 33 each) between the ages of 3-10 years undergoing different elective surgeries. Group I received intravenous propofol and intravenous suxamethonium while Group II had inhalational induction with sevoflurane in 60% nitrous oxide and oxygen. Data including intubating conditions, time to tracheal intubation and haemodynamic changes were analysed using SPSS version 18, with statistical significance set at P < 0.05. RESULTS: Using the Helbo-Hansen intubation score, the study reveals that 28 patients (85%) scored 4, 5 (15.2%) scored 5 and no patient scored 6 in Group I whereas 15 (45.5%) scored 4, 16 (48.5%) scored 5 and 2 (6.1%) scored 6 in Group II with P = 0.002. The mean time taken from induction to laryngoscopy was 91.27 ± 29.96 s in Group I and 219.09 ± 63.88 s in Group II (with P < 0.0001); mean time taken from laryngoscopy to completion of intubation was 29.03 ± 10.61 s and 28.09 ± 9.48 s which was not statistically significant with P = 0.71. CONCLUSION: Sevoflurane provides clinically acceptable intubating conditions and can be a suitable alternative to propofol-suxamethonium for endotracheal intubation in children. We recommend the use of sevoflurane to facilitate intubation in elective procedures in children.

Between pain and pleasure: Pregnant women's knowledge and preferences for pain relief in labor, a pilot study from Zaria, Northern Nigeria.

BACKGROUND: Pain relief in labor remains a hot topic and these debates get louder by the day as more women become aware of their rights to better quality of care in labor. This study was conceived in a background where the practice of pain relief in labor is evolving and where women are seeking to fulfill their need for pain-free labor. OBJECTIVE: To investigate the knowledge, utilization and preferences of methods of pain relief in labor by expectant mothers in order to design a labor analgesia program. MATERIALS AND METHODS: A questionnaire-based descriptive study involving 124 antenatal clients in a teaching hospital over a 1 week period. Descriptive statistics were carried out using SPSS for windows version 17. RESULTS: The mean age of clients was 28.8 years (standard deviation = 5.17) with median parity of two and mean gestational age was 31.5 weeks. Majority of the respondents (47.9%) were of Hausa/Fulani ethnicity and 97.6% had primary school level education. Majority (87.3%) had heard about pain relief methods with the hospital being the source in 79% of cases. The most common method ever heard about was epidural analgesia (69.4%). Only 4% (n = 5) of respondents remembered ever using any form of pain relief agent in labor, of which three received parenteral opioids. In their current pregnancies, 45.2% consented to the use of pain relief in labor; of which, epidural analgesia was preferred by 92.9% (n = 52). Fear of adverse effects on self and infants were cited as reasons for non-consent by some respondents while others had no reason. CONCLUSION: The study reveals a high awareness of pain relief methods which is not matched by utilization and low knowledge about side-effects, although fear of side-effects is a factor for under-utilization. There is a need to educate adequately as well provide high quality pain relief services in labor in order to dispel with myths, misconceptions and fears associated with the use of methods of pain relief in labor.