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1.
J Pak Med Assoc ; 74(4): 652-655, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38751256

RESUMEN

Objectives: To investigate the effect of lengthy mask use on blood gas values and cognitive functions. METHODS: The cross-sectional study was conducted in February and March 2022 at Mersin City Training and Research Hospital, Mersin, Turkey, and comprised healthcare professionals of either gender aged 20-60 years working in the 3rd level intensive care unit. Each volunteer was subjected to venous blood gas analysis at the beginning and end of the 8-hour morning shift. Coronavirus disease-2019 status was noted, and further data related to cognitive functions was collected using a 7-item questionnaire. Data was analysed using SPSS 20. RESULTS: Of the 63 subjects, 43(68.3%) were women and 20(31.7%) were men. The overall mean age was 33.53±6.76 years. There were 42(66.7%) subjects using N95 mask; 27(64.3%) women and 15(35.7%) men with mean age 32.38±6.54 years. There were 21(33.3%) subjects wearing surgical masks; 16(76.2%) women and 5(23.8%) men with mean age 35.95±0.76 years. Intergroup comparisons were non-significant for all the markers (p>0.05). Within the N95 mask group, potential of hydrogen and lactate values were significantly different (p<0.05), while in the surgical mask group, potential of hydrogen and partial pressure of oxygen were significantly different (p<0.05). There were 28(66.7%) subjects in the N95 group who had been affected by coronavirus disease-2019 compared to 16(76.2%) in the surgical mask group (p>0.05). Subjects in the N95 mask group had significant impaired cognitive functions compared to the surgical mask group (p<0.05). Conclusion: Impairment in cognitive functions in intensive care unit workers using masks could be explained by the development of intermittent long-term moderate hypoxia.


Asunto(s)
Análisis de los Gases de la Sangre , COVID-19 , Personal de Salud , Máscaras , SARS-CoV-2 , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Masculino , Femenino , Adulto , Estudios Transversales , Personal de Salud/psicología , Personal de Salud/estadística & datos numéricos , Turquía , Cognición , Persona de Mediana Edad , Adulto Joven , Respiradores N95
2.
J Clin Monit Comput ; 36(6): 1785-1793, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-35141803

RESUMEN

Intubation is required to maintain anesthesia in patients who are planned to undergo surgery under general anesthesia. One of the most important steps for successful intubation is to position head and neck appropriately. Sniffing position, head extension position, and neutral head position are the most known and used head and neck positions. The aim of this study is to examine the effect of head position on glottic visualization with McGrath MAC® video laryngoscope (VL) and intubation success in obese patients who are scheduled for surgery. A total of 150 patients, 50 patients in each group, with a body mass index of 30 and above were included in the study. The patients included in the study were divided into three groups: neutral head position, head extension position and sniffing position. During the intubation with McGrath MAC® VL, the groups were compared in terms of percent of glottic opening (POGO) score, intubation duration and Intubation Difficulty Scale (IDS) score. While the POGO score was found to be statistically significantly higher in the sniffing position than in the neutral head position (p < 0.001), it was similar in the extension position. The intubation duration was found to be statistically significantly shorter in the sniffing position than in the neutral head position (p = 0.001). However, there was no statistically significant difference between sniffing and extension positions. IDS score was found to be statistically significantly higher in the neutral head position compared to the other positions (p < 0.001, p < 0.001, respectively). In addition, the IDS score was statistically significantly higher in head extension position than in sniffing position (p = 0.016). This study is a randomized controlled trial of 150 patients investigating the impact of head position on glottic visualization and intubation success in obese patients when using Macintosh-like VL. The results show that sniffing position may be favored.


Asunto(s)
Laringoscopios , Humanos , Laringoscopía/métodos , Estudios Prospectivos , Intubación Intratraqueal/métodos , Anestesia General , Obesidad
3.
BMC Oral Health ; 19(1): 59, 2019 04 18.
Artículo en Inglés | MEDLINE | ID: mdl-30999904

RESUMEN

BACKGROUND: Toothache is a common consequence of untreated caries, predisposed by poor oral hygiene and high caries risk. Most children expressed their pain through their parents or carers. The aim of this study was to determine the colour of pain presence and absence. METHODS: Patients aged between 4 and 14 and referred to a dentist for the first time due to toothache had a short-term pain of 1 month caused by deep cavities. The children chose paintings from the box of 24 standard colours (Crayola, Spain) and the circles were painted. Pain was rated by children on the Visual Analoge Scale. Normality and variance were tested using the one-sample Kolmogorov-Smirnov test. Associations were performed by using the Pearson correlation coefficient. Analyses were completed by using the Statistical Package for Social Sciences (SPSS Inc., Chicago, IL) version 20.0 program. RESULTS: A total of 147 patients including 78 girls (53.1%) and 69 boys (46.9%) were included in the study. The principal component analysis showed that red has the highest factor loading in children with pain, whereas yellow was the other highest one in children without pain. CONCLUSION: The presence of pain was mainly associated with red, and the absence of pain was associated with yellow in Turkish population. Description of pain with colour can be useful tool to recognize the children and to improve dentist-patient or dentist-parents communication.


Asunto(s)
Color , Caries Dental , Odontalgia , Adolescente , Niño , Preescolar , Femenino , Humanos , Masculino , España , Turquía
4.
Pain Pract ; 19(2): 196-203, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30269430

RESUMEN

BACKGROUND: The interscalene brachial plexus block (ISBB) is an effective procedure for minimizing postoperative opioid consumption and pain following arthroscopic shoulder surgery. The ultrasound (US)-guided supraclavicular brachial plexus block (SCBB) seems to be an alternative technique for arthroscopic shoulder surgery. However, evidence is lacking regarding the impact of SCBB on postoperative pain management and recovery after arthroscopic shoulder surgery. The aim of this study was to compare the effects of SCBB with ISBB in terms of postoperative pain and quality of recovery after arthroscopic shoulder surgery. METHODS: A total of 62 adult patients scheduled for arthroscopic shoulder surgery under general anesthesia were randomized into 2 groups to receive either ISBB (IB group, n = 31) or SCBB (SB group, n = 29) with 20 mL of 0.25% bupivacaine under US guidance. Assessments included postoperative pain scores, additional analgesic requirement, timing of the first analgesic requirement, Quality of Recovery-40 (QoR-40) scores, block characteristics, and side effects. RESULTS: No significant differences were found between the 2 groups for pain scores (P = 0.34), timing of first analgesic requirement (P = 0.30), additional analgesic requirement (P = 0.34), or QoR-40 scores (P = 0.13). The block characteristics regarding procedure time (P = 0.95), block failure, and onset time of sensory blockade (P = 0.33) were similar. Horner's syndrome occurred in 8 patients in the IB group and 1 patient in the SB group (P = 0.015). CONCLUSIONS: This study showed that US-guided SCBB is as effective as ISBB in reducing postoperative pain and improving the quality of recovery for arthroscopic shoulder surgery.


Asunto(s)
Bloqueo del Plexo Braquial/métodos , Manejo del Dolor/métodos , Dolor Postoperatorio/cirugía , Ultrasonografía Intervencional/métodos , Adulto , Anciano , Artroscopía/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Hombro/cirugía
5.
BMC Anesthesiol ; 18(1): 111, 2018 08 17.
Artículo en Inglés | MEDLINE | ID: mdl-30115011

RESUMEN

BACKGROUND: The optimal position for surgery is one in which the patient is provided the best possible surgical intervention and put at minimum risk. Different surgical positions may cause changes in tissue perfusion. This study investigates the relationship between surgical patient positions and perfusion index. METHODS: A sample of 61 healthy individuals with no peripheral circulatory disorders, chronic diseases, or anemia was included in this study. Participants held six different positions: supine, prone, 45-degree sitting-supine, 45-degree supine with legs lifted, Trendelenburg (45-degrees head down), and reverse Trendelenburg (45-degrees head up). Perfusion index values were then measured and recorded after individuals held their positions for five minutes. RESULTS: Participants' perfusion index values were affected by different body positions (p < 0.05). Perfusion index was lowest in the sitting position (4.5 ± 2.5) and highest in individuals with Trendelenburg position (7.8 ± 3.8). CONCLUSION: Different body positions can cause changes in tissue perfusion. This should be considered in patient follow-up along with the perfusion index.


Asunto(s)
Oximetría , Posicionamiento del Paciente/estadística & datos numéricos , Adulto , Presión Sanguínea/fisiología , Femenino , Frecuencia Cardíaca/fisiología , Humanos , Masculino , Oxígeno/sangre , Adulto Joven
6.
J Clin Monit Comput ; 31(6): 1115-1121, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27866310

RESUMEN

Prediction of difficult laryngoscopy is still the uncovered secret of anesthetic practice. This pilot study is aimed to assess the efficacy of spirometry measurements in predicting difficult laryngoscopy compared with conventional airway assessment techniques. We enrolled 202 adults, ages 18-40 years, with an American Society of Anaesthesiologists score of I or II, scheduled for elective surgery and undergoing general anesthesia. Spirometry was used for lung capacity measurements before the operation. The Mallampati classification, neck circumference, sternomental distance, thyromental distance, maximum mouth-opening measurement, and upper lip bite test of the subjects were measured. During intubation, the Cormack-Lehane grade was recorded. Spearman's correlation analysis was used to define the linearity between spirometry outputs and airway measurements. Receiver operating curves were drawn to discriminate the predictive features of the significant values. The thyromental distance showed a higher correlation with forced inspiratory vital capacity (ρ = 0.420, P < 0.001). In a multivariate linear regression model, all spirometry measurements revealed that forced inspiratory vital capacity (ß = -2.050, P = 0.022) was the significant predictor for difficult laryngoscopy. The area under the curve for forced inspiratory vital capacity with a cut-off value of 3.1950 L while using thyromental distance as difficult laryngoscopy indicator is 0.754 and forced inspiratory vital capacity showed a sensitivity of 0.718 and specificity of 0.714 with a positive likelihood ratio of 2.5104 and negative likelihood ratio of 0.3949. Forced inspiratory vital capacity showed a close association with the prediction of difficult laryngoscopy.


Asunto(s)
Anestesiología/métodos , Laringoscopía/métodos , Espirometría/métodos , Adolescente , Adulto , Anestesia General , Área Bajo la Curva , Procedimientos Quirúrgicos Electivos , Femenino , Humanos , Complicaciones Intraoperatorias , Intubación Intratraqueal/métodos , Funciones de Verosimilitud , Masculino , Proyectos Piloto , Estudios Prospectivos , Capacidad Vital , Adulto Joven
7.
J Pak Med Assoc ; 67(6): 877-883, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28585586

RESUMEN

OBJECTIVE: To determine the effects of sevoflurane by inhalation on female reproductive hormones and ovarian tissues. METHODS: This experimental study was conducted at the Gaziosmanpasa University, Tokat, Turkey, and comprised Wistar-Albino female rats. The rats were divided into six groups; one control and five study groups. The control group (C) received 2 L/min O2 in 18 min/day for seven days; the first study group (S1) received 1 minimum alveolar concentration sevoflurane + 2 L/min O2 in 18 min/day for seven days; the second group (S2) received 1 minimum alveolar concentration sevoflurane + 2 L/min O2 in 18 min/day for seven days and no treatment for the following seven days; the third group (S3) received 1 minimum alveolar concentration sevoflurane + 2 L/min O2 in 18 min/day for 14 days; the fourth group (S4) received 1 minimum alveolar concentration sevoflurane + 2 L/min O2 in 18 min/day for 14 days and no treatment for the following seven days; and the fifth group (S5) received 1 minimum alveolar concentration sevoflurane + 2 L/min O2 in 18 min/day for 14 days and no treatment for the following 14 days. The duration of the study was 28 days in February 2015. Reproductive system hormone levels were analysed and histological assessment of the ovaries was performed. SPSS 20 was used for data analysis. RESULTS: Of the 30 rats, there were 5(16.7%) in each group. Histological injury scores in S2, S3, S4, and S5 were significantly higher than in C (p=0.016, p=0.008, p=0.016 and p=0.032, respectively). The hormone levels belonging to follicle stimulating hormone, luteinising hormone, estradiol and progesterone revealed significant alterations in all groups (p<0.05). CONCLUSIONS: Chronic exposure to sevoflurane negatively affected the histological structure of the ovary and hormonal regulation.


Asunto(s)
Anestésicos por Inhalación/farmacología , Estradiol/metabolismo , Hormona Folículo Estimulante/metabolismo , Hormona Luteinizante/efectos de los fármacos , Ovario/efectos de los fármacos , Progesterona/metabolismo , Sevoflurano/farmacología , Administración por Inhalación , Animales , Femenino , Hormona Luteinizante/metabolismo , Ovario/patología , Ratas , Ratas Wistar
8.
J Clin Monit Comput ; 30(6): 889-893, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26438656

RESUMEN

The aim of this study was to investigate the effect of the bispectral index (BIS) guided depth of anesthesia to inhibition of the oculocardiac reflex (OCR) during pediatric strabismus surgery. Patients between the ages of 3 and 16 years who were scheduled for elective strabismus surgery were randomly assigned to two groups. In Group 1 (n: 32), the BIS values of the patients were maintained at <50; in Group 2 (n: 28), the BIS values of the patients were maintained at levels greater than or equal to 50 with 4-7 % desflurane in a 50 % O2-air mixture by titrating the concentration during the surgery. The heart rates, presence of dysrhythmia, anticholinergic drug usage and the type of the operated extra ocular muscle were recorded. The incidence of OCR was 25 % in Groups 1 and 64.3 % in Group 2, (p < 0.05). Moreover, the incidence of OCR in group 2 was higher in medial rectus (MR) traction (78.9 %) than in lateral rectus (LR) traction (33.3 %) (p = 0.035), with no significant difference in Group 1 between MR (21.1 %) and LR (26.7 %) tractions (p = 0.83). We found that the lower BIS values are associated with the lower incidence of OCR in pediatric patients undergoing strabismus surgery. And our findings confirmed that the deeper anesthesia has a protective effect against the OCR.


Asunto(s)
Anestesia/métodos , Anestésicos/uso terapéutico , Reflejo Oculocardíaco , Estrabismo/cirugía , Adolescente , Niño , Preescolar , Estado de Conciencia , Desflurano , Femenino , Frecuencia Cardíaca , Humanos , Incidencia , Isoflurano/análogos & derivados , Isoflurano/uso terapéutico , Masculino , Éteres Metílicos/uso terapéutico , Monitoreo Intraoperatorio/métodos , Músculos Oculomotores/fisiología , Pediatría/métodos , Sevoflurano , Resultado del Tratamiento
9.
Health Qual Life Outcomes ; 12: 8, 2014 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-24428925

RESUMEN

BACKGROUND: The Quality of Recovery-40 questionnaire (QoR-40) is a self-rated questionnaire used to assess the postoperative recovery quality and health status of patients in the early stages following surgery; however, there is no Turkish version of the QoR-40. The aim of this study was to assess the reliability, validity, and responsiveness of the Turkish version of the QoR-40 (QoR-40 T). METHODS: After the approval of the ethics committee, a total of 137 patients completed the questionnaire during the preoperative period, on the third day, and one month after surgery. The quality of life was evaluated by using a health-related quality of life questionnaire (Short-Form Health Survey-36; SF-36) on the third day and one month after surgery. Reliability, feasibility, and validity were assessed to validate the QoR-40 T. RESULTS: The Cronbach's alpha of the global QoR-40 T on the third day after surgery was 0.936. A positive moderate correlation was obtained between the physical comfort, emotional state, physical independence, and pain dimensions of the QoR-40 T and the physical component summary, mental health, physical functioning, and bodily pain subscales of the SF-36 on the third day after surgery, respectively (physical comfort - physical component summary, ρ = 0.292, p = 0.001; emotional state - mental health, ρ = 0.252, p = 0.003; physical independence - physical functioning, ρ = 0.340, p < 0.01; pain - bodily pain, ρ = 0.381, p < 0.01). The standardized responsive mean of the total QoR-40 T was 0.62. CONCLUSIONS: The QoR-40 T showed satisfactory reliability and validity in evaluating the quality of recovery after surgery in the Turkish population.


Asunto(s)
Evaluación del Resultado de la Atención al Paciente , Recuperación de la Función , Procedimientos Quirúrgicos Operativos/efectos adversos , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Calidad de Vida/psicología , Reproducibilidad de los Resultados , Procedimientos Quirúrgicos Operativos/psicología , Encuestas y Cuestionarios/normas , Factores de Tiempo , Turquía , Adulto Joven
10.
Pain Pract ; 14(3): 245-51, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23586760

RESUMEN

BACKGROUND: In addition to the influence of tissue damage, the intensity of pain is also related to individual cognitive factors. The Pain Catastrophizing Scale (PCS) is used to measure individual tendency toward pain by inquiring about a subject's cognitive characteristics. Building on the knowledge that the venipuncture process causes severe pain and anxiety in some patients, the objective of this study was to investigate the relationship between the PCS score and venipuncture pain. METHODS: Patients were asked to complete the PCS questionnaire. Patients' demographic features, presence of chronic pain and American Society of Anesthesiologists (ASA) scores were recorded. Clinical and demographic characteristics of the patients were used for correlation with the PCS scores. Using an 11-point numeric rating scale (NRS), the patients then scored the amount of pain on cannulation. RESULTS: This prospective study was conducted with 196 patients; 31 patients were excluded for various reasons. One hundred sixty-five patients, 74 women and 91 men, were included in the evaluation. The study found that the venipuncture pain score had a significant positive correlation with the PCS score (r = 0.197, P < 0.05). With respect to age, no statistically significant differences in the PCS scores were found (P > 0.05). Female patients had a significantly higher PCS score than the males (P < 0.05). The PCS score of patients with chronic pain was found to be significantly higher in comparison with those without pain complaints (P < 0.05). CONCLUSION: There was a positive correlation between venipuncture pain and PCS score. Consequently, the venipuncture pain score could be useful in informing practitioners about a patient's pain considerations.


Asunto(s)
Catastrofización/psicología , Percepción del Dolor , Dolor/etiología , Flebotomía/efectos adversos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dolor/psicología , Dimensión del Dolor , Flebotomía/psicología , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Adulto Joven
11.
J Clin Med ; 12(19)2023 Sep 25.
Artículo en Inglés | MEDLINE | ID: mdl-37834831

RESUMEN

The aim of this study was to evaluate the relation of maternal pain catastrophizing score with children who underwent circumcision postoperative pain. This prospective cohort study was performed between March 2022 and March 2023 at Samsun University, Turkey. Demographic characteristics of mothers and children, mothers' education level, presence of chronic pain, and Beck Depression Inventory scores were recorded preoperatively. Pain catastrophizing was assessed by applying the pain catastrophizing scale (PCS) to the mothers of children who experienced postoperative circumcision pain. The mothers were divided into low-pain catastrophizing (Group 1) and high-pain catastrophizing (Group 2) group. A total of 197 mothers and sons participated in the study, with 86 (43.6%) in Group 1 and 111 (56.4%) in Group 2. Significant differences were found between the two groups in terms of the mothers' PCS scores (p < 0.001), education levels (p = 0.004), chronic pain scores (p = 0.022), and Beck Depression Inventory scores (p < 0.001). Our findings showed that children with high pain catastrophizing mothers experience greater postoperative pain than those with low pain catastrophizing mothers. This may be attributable to a mother's specific cognitive style for coping with pain, which is associated with the child's responses to painful experiences.

12.
Saudi Med J ; 43(10): 1136-1141, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-36261200

RESUMEN

OBJECTIVES: To investigate the effect of thoracolumbar interfacial plane block (TLIP) on analgesic consumption and pain score in vertebral surgery. METHODS: All patients (64 patients undergoing vertebral surgery) were randomly allocated as Group T (patients with block, n=32) and Group C (patients without block, n=32). After surgery, patient-controlled analgesia using tramadol was administered to all patients. Pain intensity was evaluated with visual analogue scale (VAS; recovery room at 1, 2, 6, 12, and 24 hours postoperative), and as rescue analgesia, morphine was administered to patients with VAS scores of >4. In this study, total tramadol consumption, the number of patients requiring morphine, VAS score, and Quality of Recovery-40 of all patients questionnaire was evaluated. RESULTS: There were important differences between the 2 groups according to mean postoperative tramadol consumption (Group T and Group C; 180 mg [100-260] vs. 210 mg [100-300]; p=0.001) and the number of patients requiring additional analgesia (n=4; 12.5% vs. n=24; 75%, p=0.000). There were important differences between the 2 groups according to the postoperative VAS pain score (p=0.000). CONCLUSION: Ultrasound-TLIP reduces analgesic consumption and pain severity after vertebral surgery. Therefore, it is an important regional analgesia technique. CLINICALTRIALSGOV GRANT NO: NCT04548076.


Asunto(s)
Bloqueo Nervioso , Tramadol , Humanos , Bloqueo Nervioso/métodos , Tramadol/uso terapéutico , Estudios Prospectivos , Analgésicos Opioides , Ultrasonografía Intervencional , Dolor Postoperatorio/tratamiento farmacológico , Dolor Postoperatorio/prevención & control , Morfina/uso terapéutico , Analgésicos
14.
Complement Ther Med ; 42: 417-421, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30670276

RESUMEN

OBJECTIVE: The purpose of this study was to compare the aromatherapy treatment effects on PONV patients using ginger, lavender and rose oils and a placebo. DESIGN: A randomized 4-armed placebo controlled study. SETTING: Gaziosmanpasa University, School of Medicine, Health Research and Application Center. INTERVENTION: The total of 184 patients were randomized into 4 groups: Aromatherapy with lavender essential oil (Lavender group), with rose essential oil (Rose group), with ginger essential oil (Ginger group) or with pure water (Placebo group). MAIN OUTCOME MEASURES: Postoperative nausea (0-3 Likert type; 0=no nausea, 1=some, 2=a lot, 3=severe) and vomiting scores (0-3 Likert type; 0=no vomiting, 1 = 1 time, 2 = 2 or 3 time, 3 = 4 times and up) and antiemetic medication requirement. RESULTS: The nausea scores at 15 min were statistically significantly different between the groups (p = 0.00). The postoperative nausea scores improved in 20 (43.5%) subjects in the placebo group, 38 (82.6%) subjects in the lavender group, 22 (47.8%) subjects in the rose group and 30 (65.2%) subjects in the ginger group (p = 0.00). There were statistically significant differences between the groups with regard to the vomiting and antiemetic drug requirements (p = 0.00). CONCLUSION: The aromatherapy can be used as an alternative or complementary method for managing PONV. Specifically, the ginger and lavender essential oils were superior to the rose oil and pure water for the aromatherapy treatments. However, further studies with larger sample sizes are necessary to confirm these results.


Asunto(s)
Antieméticos/uso terapéutico , Aromaterapia , Lavandula/química , Aceites Volátiles/uso terapéutico , Náusea y Vómito Posoperatorios/tratamiento farmacológico , Rosa/química , Zingiber officinale/química , Adulto , Anciano , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Extractos Vegetales/uso terapéutico , Aceites de Plantas/uso terapéutico , Adulto Joven
15.
Braz J Anesthesiol ; 69(5): 455-460, 2019.
Artículo en Portugués | MEDLINE | ID: mdl-31627901

RESUMEN

INTRODUCTION: Bilateral superficial cervical plexus block (BSCPB) is a common method used for analgesia in thyroid surgery. We investigated the analgesic efficacy of bilateral superficial cervical plexus block in the intraoperative and postoperative periods. MATERIALS AND METHODS: Patients (n = 46) undergoing thyroidectomy were randomly separated into the following 2 groups: the general anesthesia group (GA; n = 23) and the general anesthesia plus BSCPB group (GS; n = 23). The intraoperative analgesic requirement (remifentanil) visual analog scale (VAS) score at multiple time points during the postoperative period (after extubation, at 15 and 30 minutes and 1, 2, 6, 12, 24 and 48 hours post operation) were evaluated. Total tramadol and paracetamol consumption as well as the amount of ondansetron used was recorded. RESULTS: The intraoperative remifentanil requirement was significantly lower in the GS Group than in the GA Group (p = 0.009). The postoperative pain scores were significantly lower in the GS Group than in the GA Group at 15 (p < 0.01) and 30 (p < 0.01) minutes and 1 (p < 0.01), 2 (p < 0.01), 6 (p < 0.01), 12 (p < 0.01) and 24 (p = 0.03) hours. The postoperative tramadol requirement was significantly lower in the GS Group than in the GA Group (p = 0.01). The number of patients that used ondansetron was significantly lower in the GS Group than in the GA Group (p = 0.004). CONCLUSION: We concluded that BSCPB with 0.25% bupivacaine reduces the postoperative pain intensity and opioid dependency in thyroid surgery patients.


Asunto(s)
Analgesia/métodos , Anestesia General , Bloqueo del Plexo Cervical , Dolor Postoperatorio/prevención & control , Tiroidectomía , Adulto , Bloqueo del Plexo Cervical/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento
16.
Braz J Anesthesiol ; 68(3): 285-291, 2018.
Artículo en Portugués | MEDLINE | ID: mdl-29631876

RESUMEN

BACKGROUND AND OBJECTIVES: A transversus abdominis plane block is a peripheral block method that has been used successfully for pain relief after total abdominal hysterectomy. However, the effects of the combination of the transversus abdominis plane block and general anesthesia on analgesic and anesthetic requirements remain unclear. This randomized placebo-controlled study is aimed to evaluate the effects of transversus abdominis plane block on analgesic and anesthetic consumption during total abdominal hysterectomy under general anesthesia. METHODS: Sixty-six women undergoing total abdominal hysterectomy were randomized into two groups to receive general anesthesia alone (control group) or with transversus abdominis plane block using 20mL of 0.25% bupivacaine (transversus abdominis plane group). Intraoperative remifentanil and sevoflurane consumption were recorded. We also evaluated the postoperative pain, nausea, quality of recovery scores and rescue analgesic requirement during postoperative 24hours. RESULTS: The total remifentanil and sevoflurane consumption is significantly lower in transversus abdominis plane group; respectively mean (SD) 0.130 (0.25) vs. 0.094 (0.02) mcg.kg-1.min-1; p<0.01 and 0.295 (0.05) vs. 0.243 (0.06) mL.min-1; p<0.01. In the postoperative period, pain scores were significantly reduced in transversus abdominis plane group soon after surgery; median (range) 6 (2-10) vs. 3 (0-5); p<0.001, at 2h (5 [3-9] vs. 2.5 [0-6]; p<0.001), at 6h (4 [2-7] vs. 3[0-6], p<0.001), at 12h (3.5 [1-6] vs. 2 [1-5]; p=0.003). The patients in the transversus abdominis plane group had significantly higher QoR-40 scores 190.5 (175-197) vs. 176.5 (141-187); p<0.001). CONCLUSION: Combining transversus abdominis plane block with general anesthesia can provide reduced opioid and anesthetic consumption and can improve postoperative pain and quality of recovery scores in patients undergoing total abdominal hysterectomy.

17.
Minerva Anestesiol ; 84(10): 1134-1141, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-29338141

RESUMEN

BACKGROUND: Blocking the femoral nerve reduces postoperative pain and analgesic consumption in patients who have undergone total knee and hip replacement surgery. A limited number of studies have compared the efficacy of the fascia iliaca compartment and femoral nerve block techniques. Therefore, this study aimed to investigate the analgesic effectiveness of fascia iliaca compartment block (FIB) and femoral nerve block using ultrasound. METHODS: A total of 100 patients were included in the study. Patients were divided into two randomized and equal groups (Group I had patients who underwent fascia iliaca compartment block, N.=50; Group II had patients who underwent femoral nerve block, N.=50). Visual Analogue Scale levels (VAS) in the postoperative 30th min and 1st, 2nd, 6th, 12th and 24th hours and the amounts of analgesic consumption were recorded. The Quality of Recovery-40 (QoR-40) questionnaire was completed by patients 24 hours after surgery. RESULTS: The VAS level at the 24th hour was significantly lower in Group I compared to Group II. Analgesic consumption between 0-30th minutes was lower in Group II than in Group I; however, it was significantly lower in the 6-24 hours of Group I compared to Group II. The QoR-40 score was found to be significantly higher in Group I than Group II. CONCLUSIONS: Femoral nerve block provided more potent analgesia in the first six hours after operation. After six hours, FIB demonstrated better pain control. The quality of postoperative recovery was higher in patients with fascia iliaca compartment block.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Bloqueo Nervioso , Dolor Postoperatorio/tratamiento farmacológico , Anciano , Fascia , Femenino , Nervio Femoral , Humanos , Masculino , Persona de Mediana Edad , Bloqueo Nervioso/métodos , Estudios Prospectivos , Método Simple Ciego , Resultado del Tratamiento
18.
Saudi Med J ; 39(10): 1006-1010, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30284583

RESUMEN

OBJECTIVES: To evaluate the possible value of the perfusion index (PI) as a tool for pain assessment. Methods: This prospective, observational study was performed with 89 patients underwent surgery with general anesthesia. The patients with visual analog scale (VAS) greater than 3 were grouped as M1, and patients with VAS≤3 and performed morphine were grouped as M2. After surgery patients with VAS greater than 3 were given 2mg morphine. Patients with VAS greater than 3 were given increments of intravenous morphine (2 mg) at 20 minute intervals until VAS less than 3. The correlation and difference between PI and VAS score values were evaluated before and after analgesic administration. Results: Significant changes were found in both PI values and VAS scores between M1 and M2 groups (2.80±0.77, 3.97±0.94, p less than 0.001; 6.60±1.20, 2.74±0.46, p less than 0.001) Despite no correlation was found between PI values and VAS scores of M1 and M2 groups, weak negative correlation was detected between differences in PI values and VAS scores among groups (r=-0.255, p=0.016). Conclusion: Perfusion index is a parameter that can be used in the assessment of postoperative pain and responses to analgesics.


Asunto(s)
Velocidad del Flujo Sanguíneo , Dolor Postoperatorio/diagnóstico , Dolor Postoperatorio/prevención & control , Escala Visual Analógica , Adulto , Analgésicos Opioides/administración & dosificación , Anestesia General , Femenino , Humanos , Masculino , Persona de Mediana Edad , Morfina/administración & dosificación , Oximetría , Estudios Prospectivos
19.
Turk J Obstet Gynecol ; 14(4): 228-232, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29379665

RESUMEN

OBJECTIVE: A permanent balance exists between the production and elimination of reactive oxygen species in all living organisms. The aim of this study was to evaluate the effects of sevoflurane possibly causing an imbalance in the equation of reactive oxygen species on the female rat reproductive system. MATERIALS AND METHODS: A total of 30 adult female Wistar-albino rats were placed into an anesthesia chamber to administer sevoflurane. Rats were randomly divided into six groups, each group consisting of five rats: the control group received 2 L/min O2 18 min/day for seven days; the first group received 1 minimum alveolar concentration (MAC) of sevoflurane and 2 L/min O2 18 min/day for seven days; the second group received 1 MAC of sevoflurane and 2 L/min O2 18 min/day for seven days with no treatment for the next seven days; the third group received 1 MAC of sevoflurane and 2 L/min O2 18 min/day for 14 days; the fourth group received 1 MAC of sevoflurane and 2 L/min O2 18 min/day for 14 days with no treatment for the next seven days; and the fifth group received 1 MAC of sevoflurane and 2 L/min O2 18 min/day for 14 days with no treatment for the next 14 days. Bilateral ovaries were subsequently removed for biochemical analysis of tissue anti-oxidative enzyme levels. RESULTS: Slight fluctuations were detected in mean nitric oxide, prostaglandin E2, prostaglandin F2-alpha, superoxide dismutase, glutathione peroxidase, malondialdehyde, alginate dialdehyde, and xanthine oxidase levels between the groups; however, the differences were not significant (p>0.05). CONCLUSION: Sevoflurane has no effect on the activity of anti-oxidant systems in the rat ovary.

20.
Turk J Anaesthesiol Reanim ; 45(3): 158-163, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28752006

RESUMEN

OBJECTIVE: Postoperative cognitive dysfunction (POCD) is common after anaesthesia in elderly patients. However, it may appear in patients of all ages. The main pathogenesis of cognitive dysfunction remains unclear, although there is some evidence that brain inflammation may alter cognitive abilities. In the present study, we aim to evaluate short-term and long-term effects of dexamethasone on cognitive dysfunction induced by sevoflurane anaesthesia in adult rats. METHODS: Seven-month-old 30 male Wistar albino rats were randomised into three groups: sevoflurane group (exposure to sevoflurane), sevoflurane + dexamethasone group (exposure to sevoflurane and dexamethasone injection), and control group (exposure to 100% oxygen). Spatial learning and short-term (7 days after exposure) and long-term (30 days after exposure) memory were evaluated using Morris water maze test. RESULTS: Sevoflurane induced significant deficit in spatial learning and short-term and long-term memory in adult rats. Dexamethasone-treated animals exposed to sevoflurane had equivalent performance as control animals in training and probe trials. CONCLUSION: Sevoflurane may impair spatial learning and short-term and long-term memories in adult rats. The co-administration of dexamethasone and sevoflurane may ameliorate short-term and long-term cognitive dysfunctions induced by sevoflurane in adult rats.

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