Comparative Study of Oral Midazolam Syrup and Intranasal Midazolam Spray for Sedative Premedication in Pediatric Surgeries.

INTRODUCTION: Midazolam is a water-soluble benzodiazepine which is frequently administered by intravenous and oral routes. Its nasal spray has become recently available. MATERIALS AND METHODS: In this study, after obtaining clearance from the ethical committe, 66 patients between the age group of 4 and 10 years comparable in demographic variables were randomly allocated into two groups of 33 each. Group "O" received oral midazolam (0.5 mg/kg) 20 min before induction. Group "N" received intranasal midazolam (0.2 mg/kg) 20 min before induction. The heart rate and blood pressure (systolic, diastolic, and mean) and oxygen saturation (SPO2) were recorded. STATISTICAL ANALYSIS USED: The statistical analysis was done using SPSS (Statistical Package for the Social Sciences) version 15.0 software. The values were represented in number (%) and mean±sd. RESULTS: Satisfactory sedation scores were better in nasal spray group than oral group. Satisfactory ease of induction scores, recovery times, and postanesthesia recovery scores were better in the nasal spray group than in the oral group. CONCLUSION: Nasal midazolam spray is acceptable and is a good alternative to oral midazolam as premedication in the pediatric population.

Protocol independent adaptive route update for VANET.

High relative node velocity and high active node density have presented challenges to existing routing approaches within highly scaled ad hoc wireless networks, such as Vehicular Ad hoc Networks (VANET). Efficient routing requires finding optimum route with minimum delay, updating it on availability of a better one, and repairing it on link breakages. Current routing protocols are generally focused on finding and maintaining an efficient route, with very less emphasis on route update. Adaptive route update usually becomes impractical for dense networks due to large routing overheads. This paper presents an adaptive route update approach which can provide solution for any baseline routing protocol. The proposed adaptation eliminates the classification of reactive and proactive by categorizing them as logical conditions to find and update the route.

A case of negative pressure pulmonary edema in an asthmatic patient after laparoscopic cholecystectomy.

Negative pressure pulmonary edema is often misdiagnosed or can go clinically unrecognized by anesthesiologists. It is characterized by a markedly low intrapleural pressure which leads to exudation of fluid and red blood cells in the interstitium. Recognition of patients with predisposing factors for upper airway obstruction is important in the diagnosis which is often confused with pulmonary aspiration of gastric contents. Signs and symptoms are subtle and edema is usually self-limited. Our patient was management conservatively with maintenance of a patent airway and administration of supplemental oxygen and had a successful outcome.