Follow-up of Serum Creatine Phosphokinase Levels after Ultrasound Guided Suprainguinal Fascia Iliaca Block with Bupivacaine in Total Knee Arthroplasty Patients: An Observational, Controlled Study.

OBJECTIVE: To determine the myotoxicity of bupivacaine on muscles after suprainguinal fascia iliaca block for postoperative analgesia in total knee arthroplasty (TKA) patients through changes in serum creatine phosphokinase (CPK) levels during the perioperative period. STUDY DESIGN: Observational study. Place and Duration of the Study: Postoperative Recovery Room department of Anaesthesiology and Reanimation, Samsun University, Samsun, Training and Research Hospital, Samsun, Turkiye, between December 2022 and February 2023. METHODOLOGY: Patients undergoing for the procedure of TKA surgery were recruited. (40 controls and 42 SIFIB groups). Serum CPK levels were evaluated preoperatively, at postoperative 6th hour and 24th hour. RESULTS:  From total 82 patients, 42 of them who received SIFIB as a component of multimodal analgesia had serum CPK levels comparable to those in the control group at all time points (p>0.05). While the increase in CPK level at 6th hour relative to baseline was significant in both groups (p<0.05), only the block group demonstrated a statistically significant difference between the 6th and 24th hours (p<0.05). CONCLUSION: SIFIB administration did not result in severe bupivacaine-induced myotoxicity in comparison to the control group. SIFIB administration is a safe option when used as part of multimodal analgesia in TKA. KEY WORDS:  Bupivacaine, Creatine phosphokinase, Myotoxicity, Regional anaesthesia.

Relations between the land use and land capability classification in Küçük Menderes River Basin.

The aim of this study was to analyze the relation between land use and land classes in Kucuk Menderes river basin in terms of sustainable utilization of natural resources. Landsat satellite images were used to determine the current land use, and remote sensing method was used for processing these images. Land capability classification reflects the natural environment potential of an area. The area occupied by agriculturally important lands depends on this classification. According to this, 34% were included in the 1st, 2nd, and 3rd class lands, 3% in the 4th class land, 7% in the 6th class land, 53% in the 7th class land, and 3% in the 8th class land. The most important land covers in the basin were; forest (21%), dry farming (21%), irrigated farming (17%), maquisgarrigue (11%), exposed surface (8%), settlements (3%) and water surface (2%). There was an inconsistency between the land capability classes and their usage. While the area occupied by 1st, 2nd, 3rd and 4th class lands, which should be used as agricultural lands covered 37%, the area occupied by the agricultural lands already covered 38%. This situation seemed consistent in terms of ratio, however, the fact was that 1st, 2nd, 3rd and 4th class lands were used for settlement (6%) and meadow pasture (20%); while the 5th, 6th, 7th and 8th class lands were used for agriculture (32%) and settlements (3%). This leads to some negative consequences. The massive erosion (60%) on the basin affects the lands that were inclined and lacking vegetation-cover. Basin lands became useless as a result of land degradation and erosion. To prevent this, a land use pattern suitable for the natural environment potentials of the region (land capability classes) should be used.

Comparison of LMA CTrach and Video Laryngoscope in Endotracheal Intubation.

OBJECTIVE: In this study, our objective was to compare the Cormack and Lehane (C-L) sight scores of direct laryngoscopy in endotracheal intubation with the endoscopic sight scores of the LMA CTrach and video laryngoscope. We also compared the success of endoscopy with the LMA CTrach and video laryngoscopy, intubation time, and its effects on haemodynamic and stress responses. METHODS: The study included 100 patients, with American Society of Anesthesiologists (ASA) scores I-III and aged 18-65, who will undergo elective surgery. Patients were randomly divided into two groups: Group C and Group V. The patients in both groups underwent direct laryngoscopy with a Macintosh laryngoscope, and their C-L scores were recorded. In Group C, the patients were intubated with the LMA CTrach, and in Group V, the patients were intubated with a video laryngoscope. Patients' haemodynamic parameters, oxygen saturation, end-tidal carbondioxide, and endoscopic sight scores were recorded. RESULTS: The demographic characteristics and the ASA classifications of the groups were similar. When endoscopic sight scores were compared with C-L, better sight was obtained in the LMA CTrach group; no significant difference was detected in Group V. Regarding the success of the intubation, no significant difference was detected between groups. However, when intubation times were compared, there was a significant difference between groups. The intubation time was longer in Group C. There was no difference between groups in terms of the percentage changes of haemodynamic parameters, oxygen saturation, and end-tidal carbondioxide values of the patients. CONCLUSION: In this study, when endoscopic sight scores were compared, better visualization was obtained in the LMA CTrach group. Therefore, in cases where intubation is difficult to apply in patients, the LMA CTrach can be an alternative application.