9 SCH 900776 Dialogue Suggestions
""Intussusception is the most frequent cause of bowel obstruction in children. Although enema is usually used as the initial treatment, surgery may be required in more than 50% of patients. General anesthesia (GA) has been suggested to increase the rate of enema success. The purpose of this study was to evaluate whether GA increases the success rate of reduction by air enema. In this retrospective single-center study from 1989 to the end of June 2008, patients receiving air enema for intussusception reduction were studied. Multivariable analysis using propensity score was performed to compare the success rate between patients receiving sedation or GA. The success rate of air enema increased from 72% in 1989 to the current rate of 90%. When time elapsed between first symptoms and enema was >12?h, the success rate decreased significantly (Odds Ratio 0.67 AUY922 [0.56�C0.81], P?B3GAT3 intoxicated by an i.v. ropivacaine infusion until circulatory arrest. After 1?min basic life support (chest compression and ventilation), epinephrine i.v. (10?��g��kg?1, group IV) or epinephrine i.m. (100?��g��kg?1, group IM) or normal saline (group NS) was applied. Further doses of epinephrine were given in group IV every 4?min and in group IM after 10?min if required. Twenty-one minutes after circulatory arrest, i.v. epinephrine �C as necessary �C was given to all animals. Thus, group NS represents late epinephrine administration. Outcomes were survival and time to ROSC. Twenty-four pigs aged 19.5 (median, interquartile range 16�C22) days, weighing click here 5.4 (5.0�C5.7) kg were investigated. Total amount of ropivacaine administered was 8.9 (8.1�C10.1) mg��kg?1. Cardiac rhythm before starting CPR was pulseless electric activity and asystole in 15 and 9 pigs, respectively. Eight, seven, and four pigs survived in group IV, IM, and NS. Focusing on surviving animals, time to ROSC was 2, 4 and 19.5?min in group IV, IM, and NS. Early i.m. epinephrine provided similar survival compared with early i.v. epinephrine and was superior to delayed epinephrine administration in resuscitation of ropivacaine-induced cardiac arrest in piglets. ""George Gregory, M.D.
