RESUMO
BACKGROUND: Adenotonsillectomy is a common otolaryngology surgery. Nausea and vomiting are the most common complications of this procedure with a prevalence ranging from 49% to 73 %. OBJECTIVES: Our aim was to evaluate the effects of short time fasting protocol on decreasing postoperative pain, nausea and vomiting, and initiation of oral feeding after adenotonsillectomy. PATIENTS AND METHODS: 120 children aged 4 to 14 years candidates for adenotonsillectomy were randomly divided into intervention and control groups (n = 120, 60 in each group). Each patient of the intervention group was given oral dextrose 10% as much volume as he could consume at 3 and 6 hours prior to the operation. All the data including pain severity, nausea and vomiting of the patients, the time of oral feeding initiation etc. were gathered in checklists after the operation. Statistical analyses were then performed using Statistical Package for the Social Sciences (SPSS) software version 16. Descriptive statistical methods and mean difference test for independent groups and chi square test or Fisher exact test, and if regression needed model test were applied. A P value of 0.05 or less was considered statistically significant. RESULTS: The amount of Acetaminophen administered for the intervention group was significantly lower than the control group, and also the time of oral feeding initiation was significantly shorter in the intervention group than the control group (P < 0.005). Pain severity at all occasions following surgery was significantly lower in the intervention group than the control group (P < 0.001). Although frequency of nausea at recovery time was significantly lower in the intervention group than the control group (P < 0.002), there were no significant differences in frequency of nausea between the two groups at other postoperative occasions. Postoperative vomiting frequency was not significant between the two groups at any occasions. CONCLUSIONS: The findings of this survey showed that shortening the duration of pre-adenotonsillectomy fasting period and hydration of patients several hours prior to the operation might be effective in decreasing postoperative pain and facilitating postoperative oral feeding initiation. Nevertheless this method does not seem to prevent postoperative nausea and vomiting.
RESUMO
UNLABELLED: Objective/hypothesis A comparison of the histopathological effect of topical use of Mitomycin C and 5-Fluorouracil in preventing myringotomy closure in rats. STUDY DESIGN: clinical trial. Methods and materials The study was performed on 43 rats that were divided into three groups. Study groups (A and B) and control group (C) after bilateral cold-knife myringotomy, we applied Mitomycin C (MMC) 4mg/ml to group A, 5-Fluouracil (5FU) 50mg/ml to group B, and normal saline to group C. An examination of all ears of rats was carried out by otoscope on days 0, 1, 3, 5, 7, and then every five days up to 70 days. Each day's closed myringotomies of all groups were examined. Results The mean of post myringotomy opening time was 37, 16, and 12 days respectively in MMC, 5FU, and saline. Patency duration of MMC group was significantly long (p<0.0001), but in histopatholgical examinations, sclerosis of tympanic membrane in MMC group showed the highest patency duration (p<0.0001). Conclusion Mitomycin C significantly prolonged the duration of myringotomy patency time - longer than 5-Fluouracil and saline but with the adverse effects of tympanic membrane fibrosis.