Brazilian Journal of Anesthesiology (English Edition), 2015
Background and objectives: in this study, we aimed to investigate the effects of sevoflurane, des... more Background and objectives: in this study, we aimed to investigate the effects of sevoflurane, desflurane and propofol maintenances on serum levels of selenium, copper, zinc, iron, malondialdehyde, and glutathion peroxidase measurements, and antioxidant capacity. Methods: sixty patients scheduled for unilateral lower extremity surgery which would be performed with tourniquet under general anesthesia were divided into three groups. Blood samples were collected to determine the baseline serum levels of selenium, copper, zinc, iron, malondialdehyde and glutathion peroxidase. Anesthesia was induced using 2---2.5 mg kg −1 propofol, 1 mg kg −1 lidocaine and 0.6 mg kg −1 rocuronium. In the maintenance of anesthesia, under carrier gas of 50:50% O 2 :N 2 O 4 L min −1 , 1 MAC sevoflorane was administered to Group S and 1 MAC desflurane to Group D; and under carrier gas of 50:50% O 2 :air 4 L min −1 6 mg kg h −1 propofol and 1 g kg h −1 fentanyl infusion were administered to Group P. At postoperative blood specimens were collected again. Results: it was observed that only in Group S and P, levels of MDA decreased at postoperative 48th hour; levels of glutathion peroxidase increased in comparison to the baseline values. Selenium levels decreased in Group S and Group P, zinc levels decreased in Group P, and iron levels decreased in all three groups, and copper levels did not change in any groups in the postoperative period. Conclusion: according to the markers of malondialdehyde and glutathion peroxidase, it was concluded that maintenance of general anesthesia using propofol and sevoflurane activated
Brazilian Journal of Anesthesiology (English Edition), 2014
Background and objectives: Success rate of catheter applications is low in supraclavicular block.... more Background and objectives: Success rate of catheter applications is low in supraclavicular block. Thus, bupivacaine and levobupivacaine become important with their long effect time in single injection practices. In this study, we aimed to compare the effectiveness, side effects and complications of bupivacaine and levobupivacaine in supraclavicular block. Methods: Sixty patients aged between 20 and 65, with body weight between 50 and 100 kg, in the ASA I-II-III group who were scheduled for hand, forearm and arm surgery using supraclavicular block were randomized into two groups of 30. The patients received 30 ml 0.5% bupivacaine (Group B) or 30 ml 0.5% levobupivacaine (Group L). Motor and sensory blocks were evaluated. Motor and sensory block onset times, total block durations, postoperative pain, amount of postoperative analgesic used and patient satisfaction were recorded. Results: Demographic data, distribution of surgical area and hemodynamic data were similar between the two groups. Surgery, motor and sensory block durations of Group B and L patients did not vary statistically significantly. However, motor and sensory block onset times in Group B were significantly shorter than Group L (p < 0.05). The mean time for first postoperative analgesic demand were 16.6 ± 8.0 h in Group B and 14.4 ± 7.3 h in Group L (p > 0.05). Conclusion: 30 ml 0.5% bupivacaine and levobupivacaine provide similar block characteristics for supraclavicular block. Bupivacaine leads to faster motor and sensory block onset compared to levobupivacaine however similar duration of postoperative analgesia.
International Journal of Obstetric Anesthesia, 2010
We present the successful use of perioperative non-invasive mechanical ventilation in a morbidly ... more We present the successful use of perioperative non-invasive mechanical ventilation in a morbidly obese pregnant woman with bronchial asthma, severe preeclampsia and pulmonary edema undergoing an emergency cesarean delivery with spinal anesthesia. The combination of non-invasive mechanical ventilation with neuraxial anesthesia may be of value in selected parturients with acute or chronic respiratory insufficiency requiring surgery.
Objetivos y justifi cativa: Nuestro estudio tuvo como objetivo investigar el efecto de la bupivac... more Objetivos y justifi cativa: Nuestro estudio tuvo como objetivo investigar el efecto de la bupivacaína y la levobupivacaína en la duración de las dispersiones del QT, QT corregido (QTc) y de la onda P durante la raquianestesia en cesárea. Métodos: Sesenta parturientes programadas para cesárea electiva en grupos de riesgo ASA I-II fueron incluidas en el estudio. Los exámenes electrocardiográfi cos (ECG) se hicieron después de la entrada de las pacientes al quirófano. Se registraron la frecuencia cardíaca (FC), presión arterial no invasiva (PANI), saturación periférica de oxígeno (SpO 2 ) y frecuencia respiratoria (RR). Para el acceso venoso, se usó una cánula de calibre 18. La precarga de líquidos fue hecha con una solución de Ringer con lactato (10 mL.kg -1 ). Después de la precarga de líquidos, un segundo examen electrocardiográfi co se hizo y las pacientes fueron designadas aleatoriamente para dos grupos. El Grupo B (n = 30) recibió 10 mg de bupivacaína y el Grupo L (n = 30) recibió 10 mg de levobupivacaína para la raquianestesia. Los exámenes ECG se repitieron en los minutos 1, 5 y 10 después de la anestesia. FC, PANI, SpO 2 , FR y los niveles de bloqueo sensorial también fueron registrados en los mismos intervalos de tiempo. En intervalos de tiempo predeterminados de raquianestesia, las duraciones de la dispersión de la onda P (OPd), QT (QTd) y QTc (QTcd) fueron medidas a partir de los registros del ECG. Las duraciones de QT y QTc fueron calculadas con la fórmula de Bazzett.
Kaohsiung Journal of Medical Sciences (2013) 29, 75e81 (ATR). In both groups, MDA levels decrease... more Kaohsiung Journal of Medical Sciences (2013) 29, 75e81 (ATR). In both groups, MDA levels decreased at 5 and 20 minutes ATR when compared with the basal values (p < 0.05). TAC levels decreased at 1 and 5 minutes ATR and then returned to basal values at 20 minutes ATR (p < 0.05). In reference to the prevention of lipid peroxidation in tourniquet-induced ischemia-reperfusion injury, the results from the two groups in our study showed that dexmedetomidine did not have an additional protective role during routine general anesthesia.
Background and objectives: In our study we aimed to investigate the effect of esmolol, lidocaine ... more Background and objectives: In our study we aimed to investigate the effect of esmolol, lidocaine and fentanyl on P-wave dispersion (Pwd), QT and corrected QT (QTc) durations and hemodynamic responses to endotracheal intubation during propofol induction. Methods: A total of eighty adult patients, American Society of Anesthesiologists (ASA) Physical Status I or II aged 18 to 60 years were included in this prospective, randomised, double-blind study. All patients had control electrocardiograms (ECGs) done before anesthesia induction. The patients were randomised into four equal groups. The control group (Group C) received saline 5 mL, the esmolol group (Group E) received esmolol 0.5 mg.kg -1 , the fentanyl group (Group F) received fentanyl 2 μg.kg -1 and the lidocaine group (Group L) received lidocaine 1.5 mg.kg -1 before
Brazilian Journal of Anesthesiology (English Edition), 2015
Background and objectives: it has been demonstrated that smoking increases pain perception; howev... more Background and objectives: it has been demonstrated that smoking increases pain perception; however the effect of smoking on perception of pain during venous cannulation is not known. Aim: the purpose of this study is to determine whether or not smoking has an effect on pain perception due to peripheral venous cannulation. Methods: two hundred and twenty patients scheduled to have elective surgery were enrolled in the study and were divided into two groups (Group S and C, n = 110 for each) according to their smoking habits. Numerical rating scale was introduced to the patients and then peripheral venous cannulation at the dorsum of the hand was made with a 20 G intracath. Pain perception of the patients was scored by subsequent numerical rating scale questioning. Results: the demographic characteristics of the groups were identical. Numerical rating scale scores in Group S and C were 3.31 ± 1.56 and 1.65 ± 1.23, respectively (p < 0.001). Conclusion: pain perception due to peripheral venous cannulation is higher in smokers. Future studies on pain treatment should consider the smoking habits of patients.
We assessed the antioxidant activity of dexmedetomidine (DEX) during an ischemic period in a rat ... more We assessed the antioxidant activity of dexmedetomidine (DEX) during an ischemic period in a rat model of testicular torsion/detorsion (T/DT) by using biochemical and histopathological methods. Wistar Albino male rats weighing 250-300 g were divided into three groups: sham (group S, n = 7); torsion/detorsion (group T/DT, n = 7), and DEX treatment (group DEX, n = 7). In the T/DT group, right testes were rotated 720 degrees for 1 h. Group S served for normal basal values. Rats in group T/DT were operated to make T/DT, this group served as a control group. Group DEX received intraperitoneal DEX 10 microg . kg(-1) after the 30-min torsion period. For measurement of total antioxidant enzyme activities and malondialdehyde (MDA) levels, testes of 7 animals in each group were excised after 4 h of reperfusion. Germ cell apoptosis was evaluated using the apoptosis protease-activating factor 1 (APAF-1) antibody in all groups and also on the expressions of endothelial nitric oxide synthase (eNOS) and inducible nitric oxide synthase (iNOS) were assessed within the bilateral testes. Mean MDA levels in group T/DT were significantly higher than in groups S and DEX (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). There were also significant decreases in mean total antioxidant activities in group T/DT when compared to groups S and DEX (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). These values were significantly higher in group DEX than group T/DT. Germ cell apoptosis, eNOS and iNOS levels were significantly higher in group T/DT when compared to groups S and DEX (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). DEX treatment has potential biochemical and histopathological benefits by preventing ischemia/reperfusion-related cellular damage in an experimental testicular torsion model. Preference of DEX for anesthesia during the detorsion procedure may attenuate ischemia-reperfusion injury.
Background and Objectives: In our study we aimed to investigate the effect of bupivacaine and lev... more Background and Objectives: In our study we aimed to investigate the effect of bupivacaine and levobupivacaine on QT, corrected QT (QTc), and P wave dispersion durations during spinal anesthesia in cesarean section. Methods: Sixty parturients scheduled for elective cesarean section in ASA I-II risk groups were included in the study. Baseline electrocardiographic (ECG) records of the patients were obtained in the operation room. Heart rate (HR), non-invasive blood pressure (NIBP), peripheral oxygen saturation (SpO 2 ) and respiration rates (RR) were recorded. Venous cannulation was performed with 18G cannula and fl uid preload made with 10 mL.kg -1. Lactated Ringer solution. After fl uid preload, second ECG recordings were taken and the patients were randomly separated into two groups. Group B (n = 30) received 10 mg of bupivacaine and Group L (n = 30) received 10 mg of levobupivacaine for spinal anesthesia. ECG recordings were repeated at 1, 5 and 10 minutes after spinal block. HR, NIBP, SpO 2 , RR and sensory block levels were also recorded at the same time intervals. At predetermined time intervals of spinal anesthesia, P wave dispersion (Pwd), QT dispersion (QTd), and QTc dispersion (QTcd) durations were measured from ECG records. QT and QTc durations are calculated with Bazzett formula.
Brazilian Journal of Anesthesiology (English Edition), 2015
Background and objectives: In this study, we investigated the anesthetic and mucosal effects of t... more Background and objectives: In this study, we investigated the anesthetic and mucosal effects of the rectal application of dexmedetomidine to rats. Methods: Male Wistar albino rats weighing 250---300 g were divided into four groups: Group S (n = 8) was a sham group that served as a baseline for the normal basal values; Group C (n = 8) consisted of rats that received the rectal application of saline alone; Group IPDex (n = 8) included rats that received the intraperitoneal application of dexmedetomidine (100 g kg −1 ); and Group RecDex (n = 8) included rats that received the rectal application of dexmedetomidine (100 g kg −1 ). For the rectal drug administration, we used 22 G intravenous cannulas with the stylets removed. We administered the drugs by advancing the cannula 1 cm into the rectum, and the rectal administration volume was 1 mL for all the rats. The latency and anesthesia time (min) were measured. Two hours after rectal administration, 75 mg kg −1 ketamine was administered for intraperitoneal anesthesia in all the groups, followed by the removal of the rats' rectums to a distal distance of 3 cm via an abdominoperineal surgical procedure. We histopathologically examined and scored the rectums. Results: Anesthesia was achieved in all the rats in the Group RecDex following the administration of dexmedetomidine. The onset of anesthesia in the Group RecDex was significantly later and of a shorter duration than in the Group IPDEx (p < 0.05). In the Group RecDex, the administration of dexmedetomidine induced mild---moderate losses of mucosal architecture in the colon and rectum, 2 h after rectal inoculation. Conclusion: Although 100 g kg −1 dexmedetomidine administered rectally to rats achieved a significantly longer duration of anesthesia compared with the rectal administration of saline, our * Corresponding author.
In this study, we aimed to investigate the effects of sevoflurane, desflurane and propofol mainte... more In this study, we aimed to investigate the effects of sevoflurane, desflurane and propofol maintenances on serum levels of selenium, copper, zinc, iron, malondialdehyde, and glutathion peroxidase measurements, and antioxidant capacity. 60 patients scheduled for unilateral lower extremity surgery which would be performed with tourniquet under general anesthesia were divided into three groups. Blood samples were collected to determine the baseline serum levels of selenium, copper, zinc, iron, malondialdehyde and glutathion peroxidase. Anesthesia was induced using 2-2.5 mg kg(-1) propofol, 1 mg kg(-1) lidocaine and 0.6 mg kg(-1) rocuronium. In the maintenance of anesthesia, under carrier gas of 50:50% O2:N2O 4 L min(-1), 1 MAC sevoflorane was administered to Group S and 1 MAC desflurane to Group D; and under carrier gas of 50:50% O2:air 4 Lmin(-1) 6 mg kg h(-1) propofol and 1 μg kg h(-1) fentanyl infusion were administered to Group P. At postoperative blood specimens were collected aga...
Brazilian Journal of Anesthesiology (English Edition), 2014
Success rate of catheter applications is low in supraclavicular block. Thus, bupivacaine and levo... more Success rate of catheter applications is low in supraclavicular block. Thus, bupivacaine and levobupivacaine become important with their long effect time in single injection practices. In this study, we aimed to compare the effectiveness, side effects and complications of bupivacaine and levobupivacaine in supraclavicular block. Sixty patients aged between 20 and 65, with body weight between 50 and 100 kg, in the ASA I-II-III group who were scheduled for hand, forearm and arm surgery using supraclavicular block were randomized into two groups of 30. The patients received 30 ml 0.5% bupivacaine (Group B) or 30 ml 0.5% levobupivacaine (Group L). Motor and sensory blocks were evaluated. Motor and sensory block onset times, total block durations, postoperative pain, amount of postoperative analgesic used and patient satisfaction were recorded. Demographic data, distribution of surgical area and hemodynamic data were similar between the two groups. Surgery, motor and sensory block durations of Group B and L patients did not vary statistically significantly. However, motor and sensory block onset times in Group B were significantly shorter than Group L (p&amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). The mean time for first postoperative analgesic demand were 16.6 ± 8.0 h in Group B and 14.4 ± 7.3h in Group L (p&amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). 30 ml 0.5% bupivacaine and levobupivacaine provide similar block characteristics for supraclavicular block. Bupivacaine leads to faster motor and sensory block onset compared to levobupivacaine however similar duration of postoperative analgesia.
Kaohsiung Journal of Medical Sciences (2013) 29, 75e81 (ATR). In both groups, MDA levels decrease... more Kaohsiung Journal of Medical Sciences (2013) 29, 75e81 (ATR). In both groups, MDA levels decreased at 5 and 20 minutes ATR when compared with the basal values (p < 0.05). TAC levels decreased at 1 and 5 minutes ATR and then returned to basal values at 20 minutes ATR (p < 0.05). In reference to the prevention of lipid peroxidation in tourniquet-induced ischemia-reperfusion injury, the results from the two groups in our study showed that dexmedetomidine did not have an additional protective role during routine general anesthesia.
Acute lung injury Pulmonary edema Pleural effusion Inflammation a b s t r a c t Background: We as... more Acute lung injury Pulmonary edema Pleural effusion Inflammation a b s t r a c t Background: We assessed the effects of dexmedetomidine in a rat model of a-naphthylthiourea (ANTU)einduced acute lung injury.
This prospective, randomized, and double-blind clinical study aimed to assess the analgesic effic... more This prospective, randomized, and double-blind clinical study aimed to assess the analgesic efficacy of single-dose intramuscular (IM) injection of dexketoprofen (group DE) compared with single-dose IM injection of diclofenac (group DI) in patients who were undergoing shockwave lithotripsy (SWL). A total of 70 men with single renal or ureteral stones were randomly separated into two groups. The 40 men in group DI received 75 mg IM diclofenac sodium and 30 men in Group DE received 50 mg IM dexketoprofen trometamol 30 minutes before SWL. A 10-point visual analog scale was used to evaluate pain. The age, body mass index, and mean stone burden were comparable between the two groups (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). The mean visual analog scale score for group DE was statistically lower compared with the score for group DI (P = 0.02). In 34 (85%) of the 40 men in group DI, the SWL procedure was performed with no, minor, or tolerable pain. In group DE, however, 28 (93.3%) of 30 patients evaluated the pain severity as no, minor, or tolerable (p = 0.01). No major/minor adverse effects were observed in group DI, whereas in one patient in group DE, dyspepsia after injection was noticed (P = 0.423). The severity of SWL-related pain was significantly better tolerated with dexketoprofen trometamol. During an SWL procedure, the analgesic efficacy of dexketoprofen was greater than that of diclofenac sodium. Although statistically insignificant, a little increased risk for gastric irritation was noticed with dexketoprofen.
This prospective, double-blind and randomized study is designed to determine the effect of menstr... more This prospective, double-blind and randomized study is designed to determine the effect of menstrual cycle on the injection pain of propofol. Seventy-two patients scheduled for elective surgery under general anaesthesia were divided into two groups according to the phase of the menstrual cycle. Patients were at follicular phase (Pd 8-12) in Group F (n = 36) and luteal phase (Pd 20-24) in Group L (n = 36). Injection pain was evaluated with 10-point numeric rating scale after 25% of the total propofol dose was injected over 20 s. There were no significant differences in terms of patient characteristics (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). The mean propofol pain score was found 1.81 +/- 2.30 in Group F and 4.83 +/- 3.09 in Group L. Group L was found to have higher propofol injection pain scores than Group F (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). We conclude that the menstrual phase changes the perception of pain due to propofol injection, which is higher in the lutheal phase. In clinical practice, the phases of the menstrual cycle may have a significant role on injection pain of propofol in woman.
We evaluated P wave dispersion (Pwd), QT, corrected QT (QTc), QT dispersion, and corrected QT dis... more We evaluated P wave dispersion (Pwd), QT, corrected QT (QTc), QT dispersion, and corrected QT dispersion (QTcd) intervals in patients with metabolic syndrome (MetS). Patients scheduled to undergo elective noncardiac surgery were included in the study. The main diagnoses, anthropometric measurements, waist circumferences, body mass index, electrocardiograms, serum levels of electrolytes, glucose, and lipids were recorded for all patients. QTc, QTcd intervals were determined with the Bazett formula. MetS (group M, n = 36) was diagnosed using the Adult Treatment Panel III. Controls (group C, n = 40) were chosen on the basis of patients with no MetS and matched for age and gender. There were no differences between groups in terms of age, sex, or serum electrolyte levels (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). Waist circumferences, body mass index, serum glucose, and triglyceride values in group M were significantly higher than those in group C (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). In group M, Pwd, QTc, QT dispersion and QTcd intervals were significantly longer than those in group C (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). This finding and our retrospective analysis suggest that these patients may be at greater risk of perioperative arrhythmias.
Brazilian Journal of Anesthesiology (English Edition), 2015
Background and objectives: in this study, we aimed to investigate the effects of sevoflurane, des... more Background and objectives: in this study, we aimed to investigate the effects of sevoflurane, desflurane and propofol maintenances on serum levels of selenium, copper, zinc, iron, malondialdehyde, and glutathion peroxidase measurements, and antioxidant capacity. Methods: sixty patients scheduled for unilateral lower extremity surgery which would be performed with tourniquet under general anesthesia were divided into three groups. Blood samples were collected to determine the baseline serum levels of selenium, copper, zinc, iron, malondialdehyde and glutathion peroxidase. Anesthesia was induced using 2---2.5 mg kg −1 propofol, 1 mg kg −1 lidocaine and 0.6 mg kg −1 rocuronium. In the maintenance of anesthesia, under carrier gas of 50:50% O 2 :N 2 O 4 L min −1 , 1 MAC sevoflorane was administered to Group S and 1 MAC desflurane to Group D; and under carrier gas of 50:50% O 2 :air 4 L min −1 6 mg kg h −1 propofol and 1 g kg h −1 fentanyl infusion were administered to Group P. At postoperative blood specimens were collected again. Results: it was observed that only in Group S and P, levels of MDA decreased at postoperative 48th hour; levels of glutathion peroxidase increased in comparison to the baseline values. Selenium levels decreased in Group S and Group P, zinc levels decreased in Group P, and iron levels decreased in all three groups, and copper levels did not change in any groups in the postoperative period. Conclusion: according to the markers of malondialdehyde and glutathion peroxidase, it was concluded that maintenance of general anesthesia using propofol and sevoflurane activated
Brazilian Journal of Anesthesiology (English Edition), 2014
Background and objectives: Success rate of catheter applications is low in supraclavicular block.... more Background and objectives: Success rate of catheter applications is low in supraclavicular block. Thus, bupivacaine and levobupivacaine become important with their long effect time in single injection practices. In this study, we aimed to compare the effectiveness, side effects and complications of bupivacaine and levobupivacaine in supraclavicular block. Methods: Sixty patients aged between 20 and 65, with body weight between 50 and 100 kg, in the ASA I-II-III group who were scheduled for hand, forearm and arm surgery using supraclavicular block were randomized into two groups of 30. The patients received 30 ml 0.5% bupivacaine (Group B) or 30 ml 0.5% levobupivacaine (Group L). Motor and sensory blocks were evaluated. Motor and sensory block onset times, total block durations, postoperative pain, amount of postoperative analgesic used and patient satisfaction were recorded. Results: Demographic data, distribution of surgical area and hemodynamic data were similar between the two groups. Surgery, motor and sensory block durations of Group B and L patients did not vary statistically significantly. However, motor and sensory block onset times in Group B were significantly shorter than Group L (p < 0.05). The mean time for first postoperative analgesic demand were 16.6 ± 8.0 h in Group B and 14.4 ± 7.3 h in Group L (p > 0.05). Conclusion: 30 ml 0.5% bupivacaine and levobupivacaine provide similar block characteristics for supraclavicular block. Bupivacaine leads to faster motor and sensory block onset compared to levobupivacaine however similar duration of postoperative analgesia.
International Journal of Obstetric Anesthesia, 2010
We present the successful use of perioperative non-invasive mechanical ventilation in a morbidly ... more We present the successful use of perioperative non-invasive mechanical ventilation in a morbidly obese pregnant woman with bronchial asthma, severe preeclampsia and pulmonary edema undergoing an emergency cesarean delivery with spinal anesthesia. The combination of non-invasive mechanical ventilation with neuraxial anesthesia may be of value in selected parturients with acute or chronic respiratory insufficiency requiring surgery.
Objetivos y justifi cativa: Nuestro estudio tuvo como objetivo investigar el efecto de la bupivac... more Objetivos y justifi cativa: Nuestro estudio tuvo como objetivo investigar el efecto de la bupivacaína y la levobupivacaína en la duración de las dispersiones del QT, QT corregido (QTc) y de la onda P durante la raquianestesia en cesárea. Métodos: Sesenta parturientes programadas para cesárea electiva en grupos de riesgo ASA I-II fueron incluidas en el estudio. Los exámenes electrocardiográfi cos (ECG) se hicieron después de la entrada de las pacientes al quirófano. Se registraron la frecuencia cardíaca (FC), presión arterial no invasiva (PANI), saturación periférica de oxígeno (SpO 2 ) y frecuencia respiratoria (RR). Para el acceso venoso, se usó una cánula de calibre 18. La precarga de líquidos fue hecha con una solución de Ringer con lactato (10 mL.kg -1 ). Después de la precarga de líquidos, un segundo examen electrocardiográfi co se hizo y las pacientes fueron designadas aleatoriamente para dos grupos. El Grupo B (n = 30) recibió 10 mg de bupivacaína y el Grupo L (n = 30) recibió 10 mg de levobupivacaína para la raquianestesia. Los exámenes ECG se repitieron en los minutos 1, 5 y 10 después de la anestesia. FC, PANI, SpO 2 , FR y los niveles de bloqueo sensorial también fueron registrados en los mismos intervalos de tiempo. En intervalos de tiempo predeterminados de raquianestesia, las duraciones de la dispersión de la onda P (OPd), QT (QTd) y QTc (QTcd) fueron medidas a partir de los registros del ECG. Las duraciones de QT y QTc fueron calculadas con la fórmula de Bazzett.
Kaohsiung Journal of Medical Sciences (2013) 29, 75e81 (ATR). In both groups, MDA levels decrease... more Kaohsiung Journal of Medical Sciences (2013) 29, 75e81 (ATR). In both groups, MDA levels decreased at 5 and 20 minutes ATR when compared with the basal values (p < 0.05). TAC levels decreased at 1 and 5 minutes ATR and then returned to basal values at 20 minutes ATR (p < 0.05). In reference to the prevention of lipid peroxidation in tourniquet-induced ischemia-reperfusion injury, the results from the two groups in our study showed that dexmedetomidine did not have an additional protective role during routine general anesthesia.
Background and objectives: In our study we aimed to investigate the effect of esmolol, lidocaine ... more Background and objectives: In our study we aimed to investigate the effect of esmolol, lidocaine and fentanyl on P-wave dispersion (Pwd), QT and corrected QT (QTc) durations and hemodynamic responses to endotracheal intubation during propofol induction. Methods: A total of eighty adult patients, American Society of Anesthesiologists (ASA) Physical Status I or II aged 18 to 60 years were included in this prospective, randomised, double-blind study. All patients had control electrocardiograms (ECGs) done before anesthesia induction. The patients were randomised into four equal groups. The control group (Group C) received saline 5 mL, the esmolol group (Group E) received esmolol 0.5 mg.kg -1 , the fentanyl group (Group F) received fentanyl 2 μg.kg -1 and the lidocaine group (Group L) received lidocaine 1.5 mg.kg -1 before
Brazilian Journal of Anesthesiology (English Edition), 2015
Background and objectives: it has been demonstrated that smoking increases pain perception; howev... more Background and objectives: it has been demonstrated that smoking increases pain perception; however the effect of smoking on perception of pain during venous cannulation is not known. Aim: the purpose of this study is to determine whether or not smoking has an effect on pain perception due to peripheral venous cannulation. Methods: two hundred and twenty patients scheduled to have elective surgery were enrolled in the study and were divided into two groups (Group S and C, n = 110 for each) according to their smoking habits. Numerical rating scale was introduced to the patients and then peripheral venous cannulation at the dorsum of the hand was made with a 20 G intracath. Pain perception of the patients was scored by subsequent numerical rating scale questioning. Results: the demographic characteristics of the groups were identical. Numerical rating scale scores in Group S and C were 3.31 ± 1.56 and 1.65 ± 1.23, respectively (p < 0.001). Conclusion: pain perception due to peripheral venous cannulation is higher in smokers. Future studies on pain treatment should consider the smoking habits of patients.
We assessed the antioxidant activity of dexmedetomidine (DEX) during an ischemic period in a rat ... more We assessed the antioxidant activity of dexmedetomidine (DEX) during an ischemic period in a rat model of testicular torsion/detorsion (T/DT) by using biochemical and histopathological methods. Wistar Albino male rats weighing 250-300 g were divided into three groups: sham (group S, n = 7); torsion/detorsion (group T/DT, n = 7), and DEX treatment (group DEX, n = 7). In the T/DT group, right testes were rotated 720 degrees for 1 h. Group S served for normal basal values. Rats in group T/DT were operated to make T/DT, this group served as a control group. Group DEX received intraperitoneal DEX 10 microg . kg(-1) after the 30-min torsion period. For measurement of total antioxidant enzyme activities and malondialdehyde (MDA) levels, testes of 7 animals in each group were excised after 4 h of reperfusion. Germ cell apoptosis was evaluated using the apoptosis protease-activating factor 1 (APAF-1) antibody in all groups and also on the expressions of endothelial nitric oxide synthase (eNOS) and inducible nitric oxide synthase (iNOS) were assessed within the bilateral testes. Mean MDA levels in group T/DT were significantly higher than in groups S and DEX (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). There were also significant decreases in mean total antioxidant activities in group T/DT when compared to groups S and DEX (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). These values were significantly higher in group DEX than group T/DT. Germ cell apoptosis, eNOS and iNOS levels were significantly higher in group T/DT when compared to groups S and DEX (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). DEX treatment has potential biochemical and histopathological benefits by preventing ischemia/reperfusion-related cellular damage in an experimental testicular torsion model. Preference of DEX for anesthesia during the detorsion procedure may attenuate ischemia-reperfusion injury.
Background and Objectives: In our study we aimed to investigate the effect of bupivacaine and lev... more Background and Objectives: In our study we aimed to investigate the effect of bupivacaine and levobupivacaine on QT, corrected QT (QTc), and P wave dispersion durations during spinal anesthesia in cesarean section. Methods: Sixty parturients scheduled for elective cesarean section in ASA I-II risk groups were included in the study. Baseline electrocardiographic (ECG) records of the patients were obtained in the operation room. Heart rate (HR), non-invasive blood pressure (NIBP), peripheral oxygen saturation (SpO 2 ) and respiration rates (RR) were recorded. Venous cannulation was performed with 18G cannula and fl uid preload made with 10 mL.kg -1. Lactated Ringer solution. After fl uid preload, second ECG recordings were taken and the patients were randomly separated into two groups. Group B (n = 30) received 10 mg of bupivacaine and Group L (n = 30) received 10 mg of levobupivacaine for spinal anesthesia. ECG recordings were repeated at 1, 5 and 10 minutes after spinal block. HR, NIBP, SpO 2 , RR and sensory block levels were also recorded at the same time intervals. At predetermined time intervals of spinal anesthesia, P wave dispersion (Pwd), QT dispersion (QTd), and QTc dispersion (QTcd) durations were measured from ECG records. QT and QTc durations are calculated with Bazzett formula.
Brazilian Journal of Anesthesiology (English Edition), 2015
Background and objectives: In this study, we investigated the anesthetic and mucosal effects of t... more Background and objectives: In this study, we investigated the anesthetic and mucosal effects of the rectal application of dexmedetomidine to rats. Methods: Male Wistar albino rats weighing 250---300 g were divided into four groups: Group S (n = 8) was a sham group that served as a baseline for the normal basal values; Group C (n = 8) consisted of rats that received the rectal application of saline alone; Group IPDex (n = 8) included rats that received the intraperitoneal application of dexmedetomidine (100 g kg −1 ); and Group RecDex (n = 8) included rats that received the rectal application of dexmedetomidine (100 g kg −1 ). For the rectal drug administration, we used 22 G intravenous cannulas with the stylets removed. We administered the drugs by advancing the cannula 1 cm into the rectum, and the rectal administration volume was 1 mL for all the rats. The latency and anesthesia time (min) were measured. Two hours after rectal administration, 75 mg kg −1 ketamine was administered for intraperitoneal anesthesia in all the groups, followed by the removal of the rats' rectums to a distal distance of 3 cm via an abdominoperineal surgical procedure. We histopathologically examined and scored the rectums. Results: Anesthesia was achieved in all the rats in the Group RecDex following the administration of dexmedetomidine. The onset of anesthesia in the Group RecDex was significantly later and of a shorter duration than in the Group IPDEx (p < 0.05). In the Group RecDex, the administration of dexmedetomidine induced mild---moderate losses of mucosal architecture in the colon and rectum, 2 h after rectal inoculation. Conclusion: Although 100 g kg −1 dexmedetomidine administered rectally to rats achieved a significantly longer duration of anesthesia compared with the rectal administration of saline, our * Corresponding author.
In this study, we aimed to investigate the effects of sevoflurane, desflurane and propofol mainte... more In this study, we aimed to investigate the effects of sevoflurane, desflurane and propofol maintenances on serum levels of selenium, copper, zinc, iron, malondialdehyde, and glutathion peroxidase measurements, and antioxidant capacity. 60 patients scheduled for unilateral lower extremity surgery which would be performed with tourniquet under general anesthesia were divided into three groups. Blood samples were collected to determine the baseline serum levels of selenium, copper, zinc, iron, malondialdehyde and glutathion peroxidase. Anesthesia was induced using 2-2.5 mg kg(-1) propofol, 1 mg kg(-1) lidocaine and 0.6 mg kg(-1) rocuronium. In the maintenance of anesthesia, under carrier gas of 50:50% O2:N2O 4 L min(-1), 1 MAC sevoflorane was administered to Group S and 1 MAC desflurane to Group D; and under carrier gas of 50:50% O2:air 4 Lmin(-1) 6 mg kg h(-1) propofol and 1 μg kg h(-1) fentanyl infusion were administered to Group P. At postoperative blood specimens were collected aga...
Brazilian Journal of Anesthesiology (English Edition), 2014
Success rate of catheter applications is low in supraclavicular block. Thus, bupivacaine and levo... more Success rate of catheter applications is low in supraclavicular block. Thus, bupivacaine and levobupivacaine become important with their long effect time in single injection practices. In this study, we aimed to compare the effectiveness, side effects and complications of bupivacaine and levobupivacaine in supraclavicular block. Sixty patients aged between 20 and 65, with body weight between 50 and 100 kg, in the ASA I-II-III group who were scheduled for hand, forearm and arm surgery using supraclavicular block were randomized into two groups of 30. The patients received 30 ml 0.5% bupivacaine (Group B) or 30 ml 0.5% levobupivacaine (Group L). Motor and sensory blocks were evaluated. Motor and sensory block onset times, total block durations, postoperative pain, amount of postoperative analgesic used and patient satisfaction were recorded. Demographic data, distribution of surgical area and hemodynamic data were similar between the two groups. Surgery, motor and sensory block durations of Group B and L patients did not vary statistically significantly. However, motor and sensory block onset times in Group B were significantly shorter than Group L (p&amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). The mean time for first postoperative analgesic demand were 16.6 ± 8.0 h in Group B and 14.4 ± 7.3h in Group L (p&amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). 30 ml 0.5% bupivacaine and levobupivacaine provide similar block characteristics for supraclavicular block. Bupivacaine leads to faster motor and sensory block onset compared to levobupivacaine however similar duration of postoperative analgesia.
Kaohsiung Journal of Medical Sciences (2013) 29, 75e81 (ATR). In both groups, MDA levels decrease... more Kaohsiung Journal of Medical Sciences (2013) 29, 75e81 (ATR). In both groups, MDA levels decreased at 5 and 20 minutes ATR when compared with the basal values (p < 0.05). TAC levels decreased at 1 and 5 minutes ATR and then returned to basal values at 20 minutes ATR (p < 0.05). In reference to the prevention of lipid peroxidation in tourniquet-induced ischemia-reperfusion injury, the results from the two groups in our study showed that dexmedetomidine did not have an additional protective role during routine general anesthesia.
Acute lung injury Pulmonary edema Pleural effusion Inflammation a b s t r a c t Background: We as... more Acute lung injury Pulmonary edema Pleural effusion Inflammation a b s t r a c t Background: We assessed the effects of dexmedetomidine in a rat model of a-naphthylthiourea (ANTU)einduced acute lung injury.
This prospective, randomized, and double-blind clinical study aimed to assess the analgesic effic... more This prospective, randomized, and double-blind clinical study aimed to assess the analgesic efficacy of single-dose intramuscular (IM) injection of dexketoprofen (group DE) compared with single-dose IM injection of diclofenac (group DI) in patients who were undergoing shockwave lithotripsy (SWL). A total of 70 men with single renal or ureteral stones were randomly separated into two groups. The 40 men in group DI received 75 mg IM diclofenac sodium and 30 men in Group DE received 50 mg IM dexketoprofen trometamol 30 minutes before SWL. A 10-point visual analog scale was used to evaluate pain. The age, body mass index, and mean stone burden were comparable between the two groups (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). The mean visual analog scale score for group DE was statistically lower compared with the score for group DI (P = 0.02). In 34 (85%) of the 40 men in group DI, the SWL procedure was performed with no, minor, or tolerable pain. In group DE, however, 28 (93.3%) of 30 patients evaluated the pain severity as no, minor, or tolerable (p = 0.01). No major/minor adverse effects were observed in group DI, whereas in one patient in group DE, dyspepsia after injection was noticed (P = 0.423). The severity of SWL-related pain was significantly better tolerated with dexketoprofen trometamol. During an SWL procedure, the analgesic efficacy of dexketoprofen was greater than that of diclofenac sodium. Although statistically insignificant, a little increased risk for gastric irritation was noticed with dexketoprofen.
This prospective, double-blind and randomized study is designed to determine the effect of menstr... more This prospective, double-blind and randomized study is designed to determine the effect of menstrual cycle on the injection pain of propofol. Seventy-two patients scheduled for elective surgery under general anaesthesia were divided into two groups according to the phase of the menstrual cycle. Patients were at follicular phase (Pd 8-12) in Group F (n = 36) and luteal phase (Pd 20-24) in Group L (n = 36). Injection pain was evaluated with 10-point numeric rating scale after 25% of the total propofol dose was injected over 20 s. There were no significant differences in terms of patient characteristics (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). The mean propofol pain score was found 1.81 +/- 2.30 in Group F and 4.83 +/- 3.09 in Group L. Group L was found to have higher propofol injection pain scores than Group F (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). We conclude that the menstrual phase changes the perception of pain due to propofol injection, which is higher in the lutheal phase. In clinical practice, the phases of the menstrual cycle may have a significant role on injection pain of propofol in woman.
We evaluated P wave dispersion (Pwd), QT, corrected QT (QTc), QT dispersion, and corrected QT dis... more We evaluated P wave dispersion (Pwd), QT, corrected QT (QTc), QT dispersion, and corrected QT dispersion (QTcd) intervals in patients with metabolic syndrome (MetS). Patients scheduled to undergo elective noncardiac surgery were included in the study. The main diagnoses, anthropometric measurements, waist circumferences, body mass index, electrocardiograms, serum levels of electrolytes, glucose, and lipids were recorded for all patients. QTc, QTcd intervals were determined with the Bazett formula. MetS (group M, n = 36) was diagnosed using the Adult Treatment Panel III. Controls (group C, n = 40) were chosen on the basis of patients with no MetS and matched for age and gender. There were no differences between groups in terms of age, sex, or serum electrolyte levels (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). Waist circumferences, body mass index, serum glucose, and triglyceride values in group M were significantly higher than those in group C (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). In group M, Pwd, QTc, QT dispersion and QTcd intervals were significantly longer than those in group C (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). This finding and our retrospective analysis suggest that these patients may be at greater risk of perioperative arrhythmias.
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