Comparative analysis of combined spinal-epidural anesthesia and general anesthesia in percutaneous nephrolithotomy: a prospective study on surgical team and operating room personnel satisfaction.

OBJECTIVE: We aimed to investigate the efficacy and complications of combined spinalepidural anesthesia and general anesthesia in percutaneous stone surgery prospectively. MATERIALS AND METHODS: The study prospectively included patients who underwent percutaneous nephrolithotomy with general anesthesia (Group.1) or combined spinal-epidural anesthesia (Group.2) at the Department of Urology, Training and Research Hospital, Karabuk University. between December 2018 and December 2019. The effect of the anesthesia technique on the comfort and satisfaction of the operating room personnel, surgeon and anesthesia team were prospectively evaluated and recorded. RESULTS: During the postoperative period, the spinal anesthesia group had a significantly lower visual analog score than the general anesthesia group. No patient in either group required narcotic analgesics during the postoperative period. In terms of overall satisfaction scores, the surgeon performing the surgical procedure had a significantly higher satisfaction score in the general anesthesia group than in the CSEA group. The score was considered good in the general anesthesia group and moderate in the CSEA group. Personnel satisfaction was higher in the patient group that underwent CSEA. In the general anesthesia group, the score was considered to be average. In the CSEA group, the satisfaction score was considered good, with a statistically significant difference (p < 0.05). The anesthesia team's satisfaction score was moderate, with no significant difference between the CSEA and general anesthesia groups (p > 0.05). CONCLUSION: PCNL under CSEA can be performed safely in certain individuals. Different anesthetic techniques may have varied levels of satisfaction among the surgical team.

Management of inhalation injury and respiratory complications in Burns Intensive Care Unit.

BACKGROUND: Inhalation injury has high mortality and carries a significant risk of permanent pulmonary dysfunction. Inhalation injury and its consequences impose difficulties for the respiratory therapists, nurses and doctors who play a central role in its clinical management. In this study, we aimed to report our clinical experience and the role of non-invasive mechanic ventilatory (NIMV) support in a series of inhalation-injured patients. METHODS: Patients hospitalized at Ankara Numune Training and Research Hospital's Burns Intensive Care Unit between March 2009 and March 2011 was reviewed, and patients with required respiratory support due to inhalation injury were included in the study. RESULTS: Among the patients, 37 had inhalation injury, and their mortality was 13.5%. Of the 37 patients, 16 had mandatory intubation (6 in the first 6 hours and 10 in the clinical course); however, others (67.8%) had only NIMV support. CONCLUSION: Application of NIMV support with proper modes decreases the need for invasive procedures in inhalation-injured patients. Based on our results, we propose the application of NIMV support in inhalation-injured burn patients.

Hot milk burns in children: a crucial issue among 764 scaldings.

BACKGROUND: Burns are among the preventable traumas encountered during childhood. Burn injuries are mostly classified as scalds, flame, electric, and chemical burns. However, each subject has some difference in the course of treatment related to the sub-etiologies. To reveal the importance of milk burns, scald burn patients were studied retrospectively. METHODS: Demographics of the patients, burn etiologies, clinical presentations, and clinical courses were analyzed. There were 461 (60.4%) male and 303 (39.6%) female patients, with a 1.52 male to female ratio. RESULTS: The mean age of the group was 3.36±2.86 years. There were no difference in burn causes between males and females. The mean burned total body surface area of patients was 16.91±12.63%. Hot milk caused larger, deeper burns than the other scalds and caused more third-degree burns (p<0.001, p<0.001, p<0.05, respectively). Milk burns also resulted in longer hospital stay (days) (p<0.001). The mortality rate was also higher in milk burns than other scalds (p<0.001). CONCLUSION: Due to the more detrimental clinical course, milk burns necessitate special consideration in clinical settings. The most important factor is to be aware that burns are deeper than they appear.