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Adenotonsillectomy is frequently performed for obstructive sleep apnoea, but is associated with post-operative respiratory morbidity. This study assessed the effect of paediatric Otrivine (0.05 per cent xylometazoline hydrochloride) on post-operative respiratory compromise.
Paediatric patients undergoing adenotonsillectomy for obstructive sleep apnoea were included. The control group (n = 24) received no intervention and the intervention group (n = 25) received intra-operative paediatric Otrivine during induction using a nasal patty. Post-operative outcomes included pain, respiratory distress signs and medical intervention level required (simple, intermediate and major).
Post-operative respiratory distress signs were exhibited by 4 per cent of the Otrivine group and 21 per cent of the control group. Sixty-eight per cent of the Otrivine group required simple medical interventions post-operatively, compared to 42 per cent of the control group. In the Otrivine group, 4 per cent required intermediate interventions; none required major interventions. In the control group, 12.5 per cent required both intermediate and major interventions. Fifty per cent of the control group reported pain post-operatively, compared with 40 per cent in the Otrivine group.
Intra-operative paediatric Otrivine may reduce post-operative respiratory compromise in paediatric patients undergoing adenotonsillectomy for obstructive sleep apnoea. A randomised controlled trial is required.
Ultrasound of the bladder is used in clinical practice as a non-invasive estimate of bladder volume when assessing post-void urinary residual. Two types of ultrasound equipment are dedicated bladder scanner and standard linear array transabdominal or transvaginal ultrasound. Ultrasound of the bladder neck can be used to assess urethral hypermobility. Increased bladder neck mobility is associated with stress urinary incontinence. The volume of the urethral sphincter can be measured using three-dimensional ultrasound. Measurement of the thickness of the bladder wall has been validated using the transvaginal, transperineal, translabial or transabdominal approach. The ultrasound is likely to be used increasingly to provide the anatomical parameters in conjunction with functional parameters provided by urodynamics. Two-dimensional and three-dimensional ultrasounds have been employed to statically and dynamically image the pelvic floor. The application of ultrasound in the identification of levator injury is currently being used as a research tool.
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