The relationship between intraoperative body temperature and thiol/disulfide balance in geriatric patients undergoing elective transurethral prostate resection surgery with spinal anesthesia.

OBJECTIVE: We aimed to investigate the relationship between intraoperative body temperature and thiol/disulfide balance in geriatric patients scheduled for elective transurethral prostate resection surgery with spinal anesthesia. PATIENTS AND METHODS: 71 patients classified as categories 1 and 2, according to American Society of Anesthesiologists (ASA) classification, were included in the study. The core temperature of the patients was recorded in the operating room after monitoring, at 5 and 30 minutes after spinal anesthesia. Total thiols, native thiols, disulfide amounts, disulfide/native thiol, disulfide/total thiol, and native thiol/total thiol were calculated as percentages after monitorization (Tpreoperative) and at 60 minutes after spinal anesthesia (Tintraoperative). RESULTS: The disulfide levels in the Tintraoperative period (29±8.9 mmol/L) were higher than the disulfide levels measured in the Tpreoperative period (18.2±8.8 mmol/L) (p<0.001). In the Tpreoperative period, the disulfide/native thiol (%) level was 4.6±2, while the disulfide/total thiol (%) level was 4.2±1.6. In the Tintraoperative period, the disulfide/native thiol (%) level was 8±2.3, while the disulfide/total thiol (%) level was 6.8±1.7. Native thiol/total thiol (%) levels for the Tpreoperative and Tintraoperative periods were 91.5±3.3 mmol/L and 86.3±3.4 mmol/L, respectively. A correlation was found between native, total thiol levels and patient age in the Tpreoperative and Tintraoperative periods. CONCLUSIONS: Oxidative stress can be reduced in geriatric patients with the possibility of developing involuntary perioperative hypothermia by regularly monitoring body temperature and applying warming techniques.

Bilateral uterine and ovarian artery ligation in addition to B-lynch suture may be an alternative to hysterectomy for uterine atonic hemorrhage.

PURPOSE OF INVESTIGATION: To evaluate the effectiveness of bilateral uterine arteries and ovarian artery ligation followed by B-Lynch compression suturing in controlling atonic postpartum hemorrhage. METHODS: In this retrospective study, the data of eight patients that had uterine atony during cesarean section and treated by bilateral uterine and ovarian artery ligation followed by B-Lynch compression suturing during the period from February 2009 to September 2010 were collected and analyzed. RESULTS: Eight cases were treated by the above protocol; the average age of the patients was 25.25 +/- 5.09 years, and the mean gestational age was 35.75 +/- 3.80 weeks. Seven of the patients were primiparous. They were hospitalized on average 5.25 +/- 2.31 days. The mean operation time was 61.25 +/- 24.60 minutes and mean estimated blood loss was 2787.5 +/- 1573.38 ml. Internal iliac artery ligation was necessary in one patient only. Hysterectomy was not performed in any of the patients. Five patients had intraoperative or postoperative blood transfusion. CONCLUSION: The addition of uterine artery and ovarian artery ligation to the B-Lynch suture may be considered as a major hemostatic step before proceeding to hysterectomy in cases of uterine atony bleeding, and all gynecologic surgeons should be familiar with it.