What anesthesiologists should know about what neurologists should know about declaring brain death.

In Rep2yy:-We regret that Drs. Black and Mackersie clearly have misunderstood the most important result of our study. Our primary goal was to find the effective dose of rectal acetaminophen in children would definitely benefit if similar study designs are carried out using other nonsteroidal antiinflammatory drugs and combinations of pain killers in children. during a day-case surgical setting. When we designed the study groups, we seriously thought to include a small-dose group (10 mg/kg) instead of a placebo group; however, our clinical impression has been that this small dose has no effect on pain. Therefore, a pure placebo group was included in the study. Our anesthesia method with sevoflurane in nitrous oxide and oxygen provides excellent cardiovascular, endocrine, and ventilatory stability for superficial surgery. Pain was assessed and treated postoperatively as effectively as possible. Therefore, we did not see ethical compromises in our study design. The design enabled us to find an effective dose of acetaminophen for 50% of subjects. Pain treatment of pediatric patients still is often guided by traditions or clinical impressions. Most likely, a balanced pain treatment approach provides better pain control than a single drug. However, to References Reijo K o r p e h , M.D. reijo. [email protected] Pekka Korvenoja, M.D. Olli Meretoja, M.D., Ph.D. Department of Anesthesia Hospital for Children and Adolescents University of Helsinki Helsinki, Finland