Dexmedetomidine added to levobupivacaine prolongs axillary brachial plexus block.

BACKGROUND AND OBJECTIVES: We evaluated the effect of adding dexmedetomidine to levobupivacaine for axillary brachial plexus blockade. The primary endpoints were the onset and duration of sensory and motor block and duration of analgesia. METHODS: Sixty patients scheduled for elective forearm and hand surgery were divided into 2 equal groups in a randomized, double-blind fashion. The 4 main nerves in the axilla (musculocutaneus, radial, median, ulnar) were identified using neural stimulation. Patients were assigned randomly to 1 of the 2 groups. In group L (n = 30), 40 mL (200 mg) of 0.5% levobupivacaine + 1 mL saline and in group LD (n = 30), 40 mL (200 mg) of 0.5% levobupivacaine + 1 mL dexmedetomidine were given. Motor and sensory block onset times, block durations, and duration of analgesia were recorded. RESULTS: Demographic data and surgical characteristics were similar in both groups. Sensory and motor block onset times were shorter in group LD than in group L (P < 0.05). Sensory and motor blockade durations were longer in group LD than in group L (P < 0.01). Duration of analgesia was longer in group LD than in group L (P < 0.05). Systolic arterial blood pressure levels in group LD at 10, 15, 30, 45, 60, 90, and 120 minutes were significantly lower than those in group L (P < 0.05). Diastolic arterial blood pressure levels in group LD at 60, 90, and 120 minutes were significantly lower than those in group L (P < 0.05). Heart rate levels in group LD, except basal measurements, were significantly lower than those in group L (P < 0.05). In group LD bradycardia was observed in 7 patients, although there was no bradycardia in group L (P < 0.05). CONCLUSIONS: Dexmedetomidine added to levobupivacaine for axillary brachial plexus block shortens the onset time and prolongs the duration of the block and the duration of postoperative analgesia. However, dexmedetomidine also may lead to bradycardia.

Royal jelly and bee pollen decrease bone loss due to osteoporosis in an oophorectomized rat model.

OBJECTIVES: In this study, we aimed to investigate whether royal jelly and bee pollen reduce the bone loss due to osteoporosis in oophorectomized rat model. MATERIALS AND METHODS: Thirty-two female Sprague-Dawley mature rats at six-month-old, weighing 180-260 g were used in the study. The rats were divided into four groups: Sham-operation group, only oophorectomy group, oophorectomy in combination with royal jelly group, and oophorectomy and bee pollen group. The rats were sacrified within 12 weeks following surgery. Bone mineral density (BMD) was measured and blood samples were collected for biochemical analysis before sacrification. Following sacrification, uterine weights were measured and tissue samples were taken to determine bone calcium and phosphate level with imaging through scanning electron microscope. RESULTS: The uterine weights of the rats were found higher in Sham-operation group than the other groups. The difference among the groups was statistically significant (p=0.001). Total body BMD results were similar in all groups and there was not statistically significant difference (p=0.19). The lumbar spine and proximal femur BMD results were statistically significantly higher in the royal jelly and bee pollen groups, compared to only oophorectomy group (p=0.001). Bone tissue calcium and phosphate levels were higher in royal jelly and bee pollen groups. CONCLUSION: Royal jelly and bee pollen decrease the bone loss due to osteoporosis in oophorectomized rat model. These results may contribute to the clinical practice.

An unusual initial presentation of Proteus syndrome: macrosyndactyly.

Proteus syndrome is a complex disorder characterized by a wide variety of deformities including macrodactyly. In the present report, we present a case with complex macrosyndactyly in his hand. The patient was surgically treated. However, he admitted with lymphangiomas on his body during the follow-up period, leading to the diagnosis of Proteus syndrome. This article discusses the differential diagnosis of Proteus syndrome and the treatment methods used for macrodactyly along with the presentation of the case.

[The results of reverse V osteotomy of the distal humerus for the correction of childhood cubitus varus deformity]. / Cocukluk çagi kubitus varus deformitelerinin düzeltilmesinde distal humerus ters V osteotomisi sonuçlari.

OBJECTIVES: In the present study we evaluated the radiological and cosmetical results of reverse V osteotomy of the distal humerus for the correction of childhood cubitus varus deformity. PATIENTS AND METHODS: Nine children (8 boys, 1 girl; mean age 9.3 years; range 4 to 16 years) treated with reverse V osteotomy between June 2004 - February 2007 were included in this study. The indication for surgery in all cases was cosmetic deformity. After the resection of a triangular bone segment, the entire distal humerus and forearm was rotated laterally to correct the deformity. Fixation was achieved with two lateral and one medial Kirschner wires. Postoperatively a posterior splint was applied in 90 degrees of elbow flexion in all cases. The results were assessed according to the criteria of Oppenheim. RESULTS: According to Oppenheim criteria, seven children had excellent and two had good results. The mean preoperative and postoperative humeral-elbow-wrist angle was -19.3 degrees (-12 degrees /-30 degrees ) and -2.4 degrees (-8 degrees /+3 degrees ), respectively. There were no short and long term complications except a transient radial nerve palsy in one case that resolved in three weeks spontaneously. CONCLUSION: Reverse V distal humerus osteotomy is a simple procedure with low complication rates and excellent results in childhood cubitus varus deformity correction.