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Objective: To review clinical experience of anesthesia management using laryngeal mask airway (LMA) during retinopathy of prematurity (ROP) photocoagulation., Methods: After obtaining the ethical approval from the Ethics Committee, we retrospectively reviewed the anesthesia records of 85 infants who underwent laser photocoagulation for ROP between June 2004 and June 2010 at the Department of Anesthesiology and Intensive Care, School of Medicine, Dokuz Eylul University, Izmir, Turkey. Anesthesia records were reviewed for airway management and respiratory complications in addition to medical and demographic data., Results: The mean gestational age was 28.61+/-2.62 weeks, birth weight was 1205.24+/-384.51 g, post-conceptional age was 38.21+/-7.01 weeks, and weight at the time of operation was 2323.9+/-588.6 g. Laryngeal mask airway was used with minimal complications in all patients, even in patients with chronic lung disease including bronchopulmonary dysplasia. After the ROP treatment, the LMA was successfully removed in all infants under deep anesthesia and none of the patients needed endotracheal intubation or ventilatory support., Conclusion: Laryngeal mask airway is a safe and easy to use alternative for airway management during laser photocoagulation procedure in infants with ROP.

Objective: The aim of the study was to compare haemodynamic responses, recovery and discharge times, and physician satisfaction of etomidate-remifentanil and propofol-remifentanil combinations in patients undergoing elective colonoscopy., Methods: Sixty patients, aged 18-65 years, scheduled for elective colonoscopy under sedation were prospectively randomized, double blind for the study. Two minutes after the beginning of a continuous remifentanil infusion (0.1 microg kg(-1) min(-1)), etomidate or propofol were administered. Patients in the etomidate group received a 0.05 mg kg(-1) maintenance dose of etomidate after an initial dose of 0.1 mg kg(-1), and patients in the propofol group received a 0.25 mg kg(-1) maintenance dose of propofol after an initial dose of 0.5 mg kg(-1) in order to have a Ramsay sedation score of 3-4. Basal values of heart rate, mean arterial pressure, oxygen saturation, respiratory rate and Ramsay sedation score were recorded. Values were recorded every 2 min for the first 10 min and every 5 min thereafter, until the completion of the procedure., Results: Mean arterial pressure was lower at 4, 6, 8, 10, 15, 20 and 25 min in the propofol group (P = 0.001). Mean respiratory rate in the propofol group at 6, 8, 10, 15, 20, 25 min was also lower (P < 0.05). The incidence of apnoea and hypotension was significantly lower in the etomidate group (P < 0.001). Arrival time into the postoperative care unit and recovery time were shorter in the etomidate group (P = 0.001, P = 0.01, respectively). Physician satisfaction in both groups was similar., Conclusion: Etomidate-remifentanil administration for sedation and analgesia during colonoscopy resulted in more stable haemodynamic responses and shorter recovery and discharge times.

Study Objective: To evaluate the effect of the neuromuscular blocking agent, rocuronium, on clinical recovery from electroconvulsive therapy (ECT) as compared with succinylcholine., Design: Cross-over study., Setting: University hospital., Patients: 13 ASA physical status I and II patients, ages 18 to 60 years, receiving ECT three times a week., Interventions: Each patient received either succinylcholine before the first ECT session (Group S) and rocuronium before the third ECT session (Group R). Muscle paralysis was produced with succinylcholine one mg kg(-1) intravenously (IV) or rocuronium 0.3 mg kg(-1) IV. Reversal of the residual neuromuscular block (Group R) was accomplished with 10 microg kg(-1)of atropine and 20 microg kg(-1)of neostigmine after completion of the ECT procedure., Measurements: Motor seizure duration time, time to first spontaneous breathing, eye opening, head lift, and tongue depressor test were recorded., Main Result: Motor seizure duration and time to first spontaneous breath was longer (33.6 sec vs. 24.2 sec; 9.46 min vs 8.07 min, respectively) in the rocuronium group than the succinylcholine group. No significant difference was detected between the two groups in eye opening, head lift, or tongue depressor testing., Conclusion: Rocuronium, when used in conjunction with a reversal agent, may be an adequate alternative to succinylcholine as a neuromuscular blocker during ECT.