Effect of ice popsicle treatment on emergence agitation in children undergoing oral surgery with sevoflurane anaesthesia: A prospective randomized controlled study.

PURPOSE: Emergence agitation is a common postoperative complication during recovery in children. The purpose of this study is to explore whether the use of ice popsicle could prevent emergence agitation in children undergoing oral surgery with sevoflurane anaesthesia. DESIGN AND METHODS: In this prospective randomized controlled study, 100 children undergoing oral surgery were randomly assigned to Group 1 which received ice popsicle after emergence (intervention, n = 50) or Group 2 which received verbal encouragement from their parents (control, n = 50). The primary outcome was the 2-hour postoperative incidence of EA. RESULTS: Group 1 had a significant lower incidence of emergence agitation (22% vs 58%, P < 0.001) compared with Group 2. The mean agitation score was significantly lower in Group 1 vs Group 2 at 10  minutes (1.64 vs 2.12, P = 0.024) and 20 min (1.60 vs 2.14, P = 0.004) after emergence. The peak agitation and pain scores were significantly lower in Group 1 than in Group 2 (P < 0.001). CONCLUSIONS: Findings from this study suggest that ice popsicle is an effective, cheap, pleasurable, and easily administered method for alleviating emergence agitation in paediatric patients after oral surgery under general anaesthesia. These results are worthy of confirmation in other surgeries. PRACTICE IMPLICATIONS: This approach is highly accepted by both children and their parents, and our findings support the effectiveness of ice popsicle in relieving emergence agitation and pain after oral surgery in children. CLINICAL TRIALS REGISTRATION: Chinese Clinical Trial Registry, ChiCTR1800015634.

The Incidence of and Risk Factors for Postoperative Fever after Cleft Repair Surgery in Children.

PURPOSE: The characteristics of postoperative fever after cleft repair surgery in children are unknown. Thus, the purpose of this study was to determine the incidence of and risk factors for postoperative fever. DESIGN AND METHODS: We retrospectively assessed 328 children who underwent cleft surgery at our hospital between March 2016 and April 2017 and were followed up for at least 3 days postoperatively. Fever was defined as a body temperature ≥38.0 °C. RESULTS: Seventy-one percent (n = 233) of patients developed fever within 72 h postoperatively, and most cases of postoperative fever were benign. Patients most frequently developed fever within 24 h postoperatively, and the occurrence of fever significantly decreased between 24 and 72 h postoperatively (p < 0.001). The incidence of fever with temperatures between 38.0 °C and 39.0 °C was higher than that of fever with temperatures ≥39.0 °C (p < 0.001). The mean duration of an episode of fever was 4 h. The type of surgery, method of anesthesia, and duration of anesthesia and surgery were found to be correlated with postoperative fever after cleft surgery. CONCLUSIONS: Most cases of postoperative fever after cleft surgery were benign occurrences. Postoperative fever after cleft repair surgery was characterized by a low grade, an early onset and a short duration in children. The method of anesthesia, duration of surgery and duration of anesthesia were risk factors for postoperative fever. PRACTICE IMPLICATIONS: Our results could help healthcare providers to gain increased knowledge of the risk factors for fever and when and how to treat postoperative fever.

Age and sex effects on the association between body composition and bone mineral density in healthy Chinese men and women.

OBJECTIVE: Many studies have examined the relationships between body composition and bone mineral density (BMD), but little attention has been given to how these relationships vary by age and sex. The aim of this study was to investigate the distributions of lean mass (LM), fat mass (FM), and BMD and the correlation between body composition and BMD in Chinese men and women of different ages. METHODS: In total, the body compositions of 1,475 men and 1,534 women aged 20 to 96 years were analyzed. Using dual-energy x-ray absorptiometry, we measured the BMD of the spine, femur, and total body and the LM, FM, and percentage of body fat (Fat %). The population was divided into groups based on age and sex: young, premenopausal, and postmenopausal women and young, middle-aged, and older men. The correlations between BMD and variables of body composition were investigated using the Pearson correlation test and multiple regression analysis. RESULTS: The peak BMD values of the spine, femur, and total body are observed in women aged 30 to 39, 20 to 29, and 30 to 39 years, respectively, and in men aged 20 to 29 years at all sites. The peak LM, FM, and Fat % values were observed at age 40 to 49, 60 to 69, and 70 to 79 years in women, respectively, and at 40 to 49, 70 to 79, and 70 to 79 years in men, respectively. A statistically significant correlation was observed between LM and BMD of all sites (r = 0.253-0.591, P < 0.01) in all groups. However, FM was significantly correlated to BMD only in postmenopausal women and older men (r = 0.089-0.336, P < 0.01). Fat % negatively correlated to BMD in young people (r = -0.169 to -0.366, P < 0.05). When stepwise regression models were analyzed, LM remained the strongest predictor of total body, spine, and femur BMD (standardized coefficients = 0.264-0.637, P < 0.001) in Chinese men and women of different ages. CONCLUSIONS: We believe that LM is the strongest predictor of BMD at all ages for Chinese men and women, even though positive correlations between FM and BMD existed in old people.