[The effects of pregabaline on postoperative pain and opioid consumption used perioperatively in patients undergoing modified radical mastectomy]. / Modifiye radikal mastektomi ameliyatlarinda perioperatif kullanilan pregabalinin ameliyat sonrasi agri ve opioid tüketimi üzerine etkisi.

OBJECTIVES: In this study, effects of pregabaline on postoperative pain and opioid consumption used perioperatively in patients undergoing modified radical mastectomy(MRM) were investigated. METHODS: Sixty ASA 1-2 patients scheduled for MRM were included. Patients were randomly divided into two and 30 patients were allocated into each group. Group Pregabaline was given pregabaline 150 mg 1 hr before operation and Group Placebo empty capsule. In both groups, anesthesia induction was obtained by penthotal, fentanyl and rocuronium and maintainence by sevoflurane, N2O and O2. Twelve hr after operation, Group Pregabaline was administered pregabaline 75 mg while Placebo group received empty capsule again. All patients received lornoxicam 8 mg iv 1 hr before end of surgery and ondansetrone 4 mg 30 min before. Patient-controlled analgesia device prepared with morphine was connected to both groups for postoperative analgesia. Postoperative VAS pain scores, hemodynamic parameters, morphine consumption, side-effects like nausea-vomiting, sedation and dizziness were followed and recorded. RESULTS: Demographic parameters were similar. VAS scores were significantly lower in Group Pregabaline at 1, 30 min, 1,4,8 and 12 hr (p<0.05). There was no significant difference in postoperative morphine consumption and need for additional dose, although they were higher in Placebo group. The patients in Placebo group had higher bothersome scores for side-effects. Hemodynamic parameters and other side-effects were similar. CONCLUSION: In our study, we showed that pregabalin administered perioperatively increased postoperative analgesic efficacy in MRM operations without making significant side effect, but did not change opioid consumption. We think that further studies about this topic must be held with different dose and patient groups.

CA 19-9 level in patients with type 2 diabetes mellitus and its relation to the metabolic control and microvascular complications.

INTRODUCTION: The aim of this study is to compare CA 19-9 levels in patients with type 2 diabetes mellitus (DM) and healthy control group. The relation of CA 19-9 levels to metabolic control and microvascular complications in patients with diabetes was also investigated. METHODS: Three hundred forty patients with type 2 DM and age-, sex- and body mass index-matched 214 healthy controls group were included in the study. HbA1(c), duration of DM and microvascular complications of DM were reviewed. CA 19-9 levels (normal range, 0-35 U/mL) were measured in all participants. RESULTS: Median CA 19-9 level was significantly higher in patients with diabetes compared with control group [19.5 U/mL (0-214.8 U/mL) versus 7.4 U/mL (0.4-47.0 U/mL)] (P < 0.001). Prevalence of high CA 19-9 levels in patients with diabetes was 31.2%, and CA 19-9 level was positively correlated with age, duration of diabetes, HbA1(c) and number of complications. Effects of duration of diabetes, HbA1(c) and diabetic nephropathy were still continuing in multiple linear regression analysis. Using regression coefficients of all variables in multiple regression analysis, this study tried to determine a new cutoff value for CA 19-9 level in patients with diabetes. The cutoff value at 97th percentile was 57.14 U/mL. CONCLUSIONS: High CA 19-9 value in patients with diabetes may indicate the need for a careful evaluation of blood glucose regulation and investigation of complications. Defining a new cutoff value in these patients would prevent unnecessary laboratory or imaging procedures.