Comparison of the Sedative Effects of Dexmedetomidine and Remifentanil in Vitrectomy Surgery: A Retrospective Study.

Background Vitrectomy surgery is a painful and lengthy procedure. Therefore, administering sedation to reduce patient agitation provides both surgical comfort and hemodynamic stability. However, various complications can arise during the perioperative period depending on the sedation agent used. In our study, we aimed to evaluate the effects of dexmedetomidine and remifentanil sedation applications on patient hemodynamics and perioperative complications in vitrectomy surgery. Methods Our retrospective study included patients aged 18-70 who underwent vitrectomy surgery between 2021 and 2022 with complete file data and ASA scores of 1-3 after obtaining approval from our hospital's ethics committee. Patients were classified into two groups based on the sedation agent used: Group D for dexmedetomidine and Group R for remifentanil. Demographic data of patients, heart rate, mean arterial pressure, oxygen saturation, and bispectral index values during perioperative monitoring, operation duration, and complications such as perioperative nausea, vomiting, and low saturation were recorded. The data of both groups were statistically evaluated, with p<0.05 values considered statistically significant. Results Because of missing data in 18 out of 58 patient files, these cases were excluded from the study. A total of 40 patients were included in the study, with 20 in Group D and 20 in Group R. The mean age of the patients was 64. Among them, 18 (45%) were male, and 22 (55%) were female. The mean operation duration was 61.8 ± 24.1 minutes in Group D and 56.3 ± 17.2 minutes in Group R. The heart rate in Group D was statistically significantly lower than in Group R, starting from the 20th minute of the perioperative period. There were no significant differences between the groups in terms of mean arterial pressure, oxygen saturation, and bispectral index values. One case of bradycardia occurred in Group D, requiring intervention. Conclusion In vitrectomy surgery, both dexmedetomidine and remifentanil infusions can be used for sedation, but caution is advised regarding bradycardia in Group D. Anticipating potential complications with an experienced anesthesia team is crucial for both patient and surgical comfort.

Retrospective evaluation of the effects of periprostatic local anesthesia on recurrent prostate biopsy.

OBJECTIVES: The aim of the study was investigate the pain palliation effect of 2% dose of lidocaine on the periprostatic nerve block in prostate biopsy patients. METHODS: Extended (12 cores) and saturation (22 cores) biopsy patients were included. The patients were separated into three groups: extended biopsy patients (Group I), saturation biopsy patients (Group II), and control group patients undergoing a biopsy procedure for the first time (Group III). All patients received 2% lidocaine (10 mL) on both the seminal vesicular junction and apex of the prostate with transrectal ultrasonography guidance. Following the procedure, the pain levels of patients were assessed using a 10-cm linear Visual Analog Scale (VAS). RESULTS: Following the procedure, the VAS values of each group were 2.96±1.06, 3.2±1.47, and 2.93±0.94, respectively (p>0.05). While the highest pain score was seen in the saturation group patients (II), the lowest pain level was seen in the control biopsy group (III). However, no statistical di erence was observed among the groups. CONCLUSION: Herein, we observed that a local injection using 2% lidocaine was effective as local anesthetic in recurrent prostate biopsies. In addition, it was found that the pain level increases as the number of cores taken in recurrent prostate biopsies increases; however, this has not been established statistically.

Intubation of a Paediatric Manikin in Tongue Oedema and Face-to-Face Simulations by Novice Personnel: a Comparison of Glidescope, Airtraq and Direct Laryngoscopy.

OBJECTIVE: Glidescope and Airtraq were designed for facilitating intubation and for teaching regarding the airway anatomy. We aimed to evaluate their efficacy in normal airway, tongue oedema and face-to-face orotracheal intubation models when used by novice personnel. METHODS: After the local human research ethics committee approval, 36 medical students who were in the beginning of their third year were enrolled in this study. After watching a video regarding intubation using one of these devices, the students intubated a paediatric manikin with a Glidescope or Airtraq via the normal airway, tongue oedema and face-to-face approach. RESULTS: Although the insertion and intubation times were similar among the groups, the intubation success rate of the Glidescope was higher in the normal airway (100% vs 67%) and tongue oedema (89% vs. 50%) compared with the Airtraq (p=0.008 and p=0.009). The success rates with the paediatric manikin by the face-to-face approach were similar among the groups (50%) (p=0.7). The need for manoeuvres in the Glidescope was lower in the normal and tongue oedema models (p=0.02 and p=0.002). In addition, oesophageal intubation was low in the control and tongue oedema models with the Glidescope (p=0.03 and p<0.001). CONCLUSION: Novice personnel could more easily intubate the trachea with the Glidescope than with the Airtraq. Intubation with the Glidescope was superior to that with the Airtraq in the normal and tongue oedema models. The face-to-face intubation success rates were both low with both the Glidescope and Airtraq groups.