Effect of Hypnosis on Pain, Anxiety, and Quality of Life in Female Patients with Fibromyalgia: Prospective, Randomized, Controlled Study.

This prospective, randomized, controlled study aimed to investigate the effects of standardized adjuvant hypnosis on pain, depression, anxiety, aerobic exercise practices, quality of life, and disease impact score in female patients with fibromyalgia syndrome (FMS). This study included 47 female patients with FMS who had been under treatment for at least six months. The hypnosis group (n = 24) received a total of three hypnosis sessions and was taught to patients' self-hypnosis. The patients in this group practiced self-hypnosis for six months. During this period, all patients also continued their medical treatment. The Visual Analogue Scale (VAS) was used to determine the intensity of pain. At the end of the six-month follow-up period, it was determined that the patients of FMS with hypnosis therapy had lower pain intensity, FMS symptoms, depression, and anxiety symptoms, and better well-being than those in the control group (p < .05). Standardized hypnosis is an effective method in reducing pain, depression and anxiety symptoms and improving quality of life in patients with FMS.

Ultrasonographic Evaluation of Gastric Content and Volume in Pediatric Patients Undergoing Elective Surgery: A Prospective Observational Study.

Anesthesia-related complications, such as pulmonary aspiration of gastric contents, occur in approximately 0.02-0.1% of elective pediatric surgeries. Aspiration risk can be reliably assessed by ultrasound examination of the gastric antrum, making it an essential non-invasive bedside tool. In this prospective observational study, since most of our patients are immigrants and have communication problems, we wanted to investigate gastric contents and the occurrence of "high risk stomach" in children undergoing elective surgery for the possibility of pulmonary aspiration, even if the children and/or parents reported their last oral intake time. This risk is defined by ultrasound findings of solid content in the antrum and/or a calculated gastric volume exceeding 1.25 mL/kg. Children aged 2-18 were included in the study. Both supine and right lateral decubitus (RLD) ultrasound examinations were performed on the antrum before surgery. Using a qualitative grading scale from 0 to 2, we evaluated the gastric fluid content. The cross-sectional area (CSA) of the antrum was measured in the RLD position, aiding the calculation of the gastric fluid volume according to an established formula by Perlas. Ultrasound measurements of 97 children were evaluated. The median fasting duration was 4 h for liquids and 9 h for thick liquids and solids. Solid content was absent in all the children. Five children (5.2%) exhibited a grade 2 antrum, implying that fluid content was visible in both the supine and RLD positions. The median antral CSA in the RLD was 2.36 cm2, with a median gastric volume of 0.46 mL/kg. For patients with a grade 0 antrum, a moderate and positive correlation was observed between the antral CSA and BMI, and a strong and positive correlation was evident between the antral CSA and age, similar to a grade 1 antrum. Only a single child (1%) had a potentially elevated risk of aspiration of gastric contents. Hence, the occurrence of a "high risk stomach" was 1% (95% confidence interval: 0.1-4.7%) and is consistent with the literature. As a necessary precaution, we propose the regular use of ultrasound evaluations of gastric contents, given their non-invasive, bedside-friendly, and straightforward implementation, for identifying risks when fasting times are uncertain and for ruling out unknown risk factors in each potential patient.

Adjuvant Hypnotherapy for Hyperemesis Gravidarum: A Randomized Pilot Study.

Hyperemesis gravidarum, which requires hospitalization in approximately 1% to 5% of patients, is characterized by severe nausea and vomiting in pregnancy. This study investigated the effects of hypnosis on nausea, vomiting, use of antiemetic medications, and hospital stay among patients diagnosed with hyperemesis gravidarum. Patients were randomized to receive either conventional therapy alone (control condition, n = 23) or adjuvant hypnotherapy plus conventional therapy (treatment group, n = 18). Sociodemographic data, severity of nausea, frequency of vomiting per day, rescue medications used, and length of hospital stay were recorded. Participants in the treatment group received 2 sessions of hypnosis and were instructed in daily self-hypnosis practice. Those in the control group received treatment as usual. Results from this study indicated that adjunctive use of hypnotherapy with patients diagnosed with hyperemesis gravidarum experienced significantly reduced severity of nausea and frequency of vomiting compared to treatment-as-usual alone. Also, hospital stay was found to be shorter in the treatment group as compared to the control group. These findings are encouraging and suggest it is feasible and potentially beneficial to include adjunctive hypnotherapy to treat hyperemesis gravidarum.

Effect of Fresh Gas Flow Rate on Thiol/Disulphide Hemostasis and Ischemia-modified Albumin in Laparoscopic Cholecystectomy.

OBJECTIVE: To investigate the effects of low-flow and high-flow anesthesia techniques, administered with sevoflurane during laparoscopic cholecystectomy, on thiol/disulphide homeostasis and serum ischemia-modified albumin (IMA) levels. STUDY DESIGN: Double-blind, randomised study. PLACE AND DURATION OF STUDY: Department of Anesthesiology and Reanimation, Health Science University, Bursa Yuksek Ihtisas Training and Education hospital, Bursa, Turkey from January to October 2020. METHODOLOGY: Patients over the age of 18 years, scheduled for elective laparoscopic cholecystectomy, were included in the study. The patients were divided into two groups: Group 1 (low-flow, 1 L/min) and Group 2 (high-flow, 2 L/min). The blood samples for thiol/disulphide homeostasis and serum IMA levels were collected as follows: 5 minutes before induction of anesthesia (T0), 5 minutes after induction of anesthesia (T1) and postoperative 24th hour (T2). RESULTS: The final analysis included 104 patients. The two groups did not differ significantly in terms of any of the demographic characteristics (p >0.05). There were also no inter-group differences in terms of thiol/disulphide homeostasis parameters or serum IMA levels at T0, T1, or T2. However, in both groups, there were statistically significant changes in serum disulphide and IMA levels from T0 to T1 and T0 to T2 (p=0.000, and p=0.005, respectively). CONCLUSION: There was no difference between low-flow and high-flow anesthesia during laparoscopic cholecystectomy in terms of hemodynamics or thiol/disulphide homeostasis. Key Words: Low-flow anesthesia, High-flow anesthesia, Thiol/disulphide homeostasis, Ischemia-modified albumin (IMA), Laparoscopic cholecystectomy.

The frequency of emergence delirium in children undergoing outpatient anaesthesia for magnetic resonance imaging.

AIM: The aim of this study was to investigate the effect on the occurrence of emergence delirium of propofol and ketofol with intranasal dexmedetomidine and midazolam applied as premedication to paediatric patients during magnetic resonance imaging (MRI). METHODS: The study included children aged 2-10 years who received sedation for MRI, separated into four groups. Group MP (midazolam-propofol) received intranasal midazolam (0.2 mg/kg) for premedication and intravenous (IV) propofol (1 mg/kg) as the anaesthetic agent. Group MK (midazolam-ketofol) received intranasal midazolam (0.2 mg/kg) for premedication and IV ketofol (1 mg/kg) as the anaesthetic agent. Group DP (dexmedetomidine-propofol) received intranasal dexmedetomidine (1 mcg/kg) for premedication and IV propofol (1 mg/kg) as the anaesthetic agent. Group DK (dexmedetomidine-ketofol) received intranasal dexmedetomidine (1 mcg/kg) for premedication and IV ketofol (1 mg/kg) as the anaesthetic agent. The Paediatric Anaesthesia Emergence Delirium (PAED) scale was used to evaluate delirium. A PAED score ≥ 10 was accepted as delirium. RESULTS: Statistical analysis was made of 140 paediatric patients. Delirium developed in 1.42% of all the patients, and in 5.7% of Group MP. The mean Aldrete and PAED scores were lower and the length of stay in the recovery room was shorter in Group DP than in the other groups. The need for additional anaesthetic was highest in Group DP at 94.3% and lowest in Group DK at 14.3%. The groups administered ketofol were observed to have a lower requirement for additional anaesthetic. CONCLUSION: Delirium was seen at a very low rate only in the Group MP and it is difficult to say the best combination in terms of delirium frequency. However, intranasal dexmedetomidine and IV ketofol seem to be better and safer than the other groups in terms of the need for additional doses and the number of side effects. The addition of ketamine to propofol reduces the need for additional doses with a synergistic effect.

Our anesthesia experiences in COVID-19 positive patients delivering by cesarean section: A retrospective single-center cohort study.

AIM: Pregnancy increases susceptibility to respiratory complications of viral diseases. This study aims to evaluate our anesthesia practices in pregnant women with COVID-19 undergoing cesarean section. METHODS: A total of 61 patients who underwent cesarean section and had positive Polymerase chain reaction (PCR) testing for COVID-19 with nasopharyngeal swabs were included in the study. Patient demographics and information about anesthesia were analyzed retrospectively from the patient medical files. RESULTS: A total of 61 parturients undergoing cesarean section that had positive SARS-CoV-2 PCR tests were assessed. General anesthesia was applied to only three patients (4.9%), while spinal anesthesia was administered to the remaining 58 patients (95.1%). The incidence of hypotension was 25.9% in the spinal anesthesia group. Forty-one (67.2%) parturients were asymptomatic. While the rate of pneumonia in symptomatic patients was 45% (9/20), the pneumonia incidence among all SARS-CoV-2 PCR (+) parturients was 14% (9/61). Three (4.9%) COVID-19 patients required intensive care in the perioperative period. The overall mortality rate was 1.6% (1/61) among parturients with COVID-19 undergoing cesarean section, while it was 11.1% (1/9) in patients with pneumonia. CONCLUSION: It was observed that COVID-19 is associated with mortality in pregnant women undergoing cesarean section. Spinal anesthesia was safely and effectively administered in COVID-19 parturients, especially in patients with pneumonia.

Ultrasound-guided transversus abdominis plane block for postoperative analgesia in laparoscopic cholecystectomy: A retrospective study.

OBJECTIVE: This study aimed to investigate the effects on postoperative pain of ketamine and dexmedetomidine addition to bupivacaine in a transversus abdominis plane (TAP) block in laparoscopic cholecystectomy. METHODS: A retrospective study was conducted patients who underwent ultrasound-guided TAP block in laparoscopic cholecystectomy. The patients were divided into three groups: Group BD (Bupivacaine+Dexmedetomidine), Group BK (Bupivacaine+Ketamine), and Group B (Bupivacaine). Our primary outcomes were pain scores with Visual Analogue Scale (VAS), postoperative first analgesic time and tramadol consumption in 24 hours postoperatively. Secondary outcomes were intraoperative hemodynamic changes, rescue analgesic requirement and side effects. RESULTS: The first analgesic administration time was significantly shorter in Group B and significantly longer in Group BD than the other two groups. Pain score at rest in Group B at 0th hours was significantly higher than that of Group BD and VAS pain score Group BD at 2nd hours was significantly lower than the other two groups. There was no significant difference between the groups regarding tramadol consumption and the requirement of rescue analgesics. CONCLUSION: Dexmedetomidine and ketamine can be added to the bupivacaine for the TAP block without major side-effects. The combination of dexmedetomidine and bupivacaine provides better analgesia in the first postoperative 2nd hour than other groups and hence extends the time to the first analgesic demand.

The Effect of Continuous Ventilation on Thiol-Disulphide Homeostasis and Albumin-Adjusted Ischemia-Modified Albumin During Cardiopulmonary Bypass.

OBJECTIVE: To investigate the effect of continuous lung ventilation with low tidal volume on oxidation parameters, such as thiol/disulphide homeostasis and albumin-adjusted ischemia-modified albumin (AAIMA), during cardiopulmonary bypass (CBP) in coronary artery bypass grafting (CABG). METHODS: Seventy-four patients who underwent elective CABG with CPB were included in the study. Blood samples were taken in the preoperative period, 10 minutes after CPB, and six and 24 hours postoperatively. Patients were assigned to the continuous ventilation group (Group 1, n=37) and the non-ventilated group (Group 2, n=37). The clinical characteristics, thiol/disulphide homeostasis, ischemia-modified albumin (IMA), and AAIMA levels of the patients were compared. RESULTS: A significant difference was found between the groups regarding native thiol, total thiol, and IMA levels at the postoperative 24th hour (P=0.030, P=0.031, and P=0.004, respectively). There was no difference between the groups in terms of AAIMA. AAIMA levels returned to preoperative levels in Groups 1 and 2, at the 6th and 24th postoperative hours, respectively. Length of hospital stay was significantly shorter in Group 1 (P<0.001) than in Group 2. CONCLUSION: Continuous ventilation during CPB caused an increase in native and total thiol levels, an earlier return of AAIMA levels, and shorter hospital stay. Continuous ventilation may reduce the negative effects of CPB on myocardium (Table 2, Figure 1, and Reference 31).

The effect of continuous ventilation on thiol-disulphide homeostasis and albumin-adjusted ischemia-modified albumin during cardiopulmonary bypass

Abstract Objective: To investigate the effect of continuous lung ventilation with low tidal volume on oxidation parameters, such as thiol/disulphide homeostasis and albumin-adjusted ischemia-modified albumin (AAIMA), during cardiopulmonary bypass (CBP) in coronary artery bypass grafting (CABG). Methods: Seventy-four patients who underwent elective CABG with CPB were included in the study. Blood samples were taken in the preoperative period, 10 minutes after CPB, and six and 24 hours postoperatively. Patients were assigned to the continuous ventilation group (Group 1, n=37) and the non-ventilated group (Group 2, n=37). The clinical characteristics, thiol/disulphide homeostasis, ischemia-modified albumin (IMA), and AAIMA levels of the patients were compared. Results: A significant difference was found between the groups regarding native thiol, total thiol, and IMA levels at the postoperative 24th hour (P=0.030, P=0.031, and P=0.004, respectively). There was no difference between the groups in terms of AAIMA. AAIMA levels returned to preoperative levels in Groups 1 and 2, at the 6th and 24th postoperative hours, respectively. Length of hospital stay was significantly shorter in Group 1 (P<0.001) than in Group 2. Conclusion: Continuous ventilation during CPB caused an increase in native and total thiol levels, an earlier return of AAIMA levels, and shorter hospital stay. Continuous ventilation may reduce the negative effects of CPB on myocardium (Table 2, Figure 1, and Reference 31).

Relationship between cigarette smoking and the carbon monoxide concentration in the exhaled breath with perioperative respiratory complications / Relação entre consumo de tabaco e concentração de monóxido de carbono na expiração com complicações respiratórias perioperatórias

Abstract Background The purpose of the current study was to determine the effects of preoperative cigarette smoking and the carbon monoxide level in the exhaled breath on perioperative respiratory complications in patients undergoing elective laparoscopic cholecystectomies. Methods One hundred and fifty two patients (smokers, Group S and non-smokers, Group NS), who underwent laparoscopic cholecystectomies under general anesthesia, were studied. Patients completed the Fagerstrom Test for Nicotine Dependence. The preoperative carbon monoxide level in the exhaled breath levels were determined using the piCO+ Smokerlyzer 12 h before surgery. Respiratory complications were recorded during induction of anesthesia, intraoperatively, during extubation, and in the recovery room. Results Statistically significant increases were noted in group S with respect to the incidence of hypoxia during induction of anesthesia, intraoperative bronchospasm, bronchodilator treatment intraoperatively, and bronchospasm during extubation. The carbon monoxide level in the exhaled breath and the Fagerstrom Test for Nicotine Dependence, and number of cigarettes smoked 12 h preoperatively were designated as covariates in the regression model. Logistic regression analysis of anesthetic induction showed that a 1 unit increase in the carbon monoxide level in the exhaled breath level was associated with a 1.16 fold increase in the risk of hypoxia (OR = 1.16; 95% CI 1.01-1.34; p = 0.038). Logistic regression analysis of the intraoperative course showed that a 1 unit increase in the number of cigarettes smoked 12 h preoperatively was associated with a 1.16 fold increase in the risk of bronchospasm (OR = 1.16; 95% CI 1.04-1.30; p = 0.007). While in the recovery room, a 1 unit increase in the Fagerstrom Test for Nicotine Dependence score resulted in a 1.73 fold increase in the risk of bronchospasm (OR = 1.73; 95% CI 1.04-2.88; p = 0.036). Conclusions Cigarette smoking was shown to increase the incidence of intraoperative respiratory complications while under general anesthesia. Moreover, the estimated preoperative carbon monoxide level in the exhaled breath level may serve as an indicator of the potential risk of perioperative respiratory complications.

Resumo Justificativa O objetivo deste estudo foi determinar os efeitos do tabagismo pré-operatório e o nível de monóxido de carbono no ar expirado sobre complicações respiratórias perioperatórias em pacientes submetidos a colecistectomias laparoscópicas eletivas. Métodos No total, 152 pacientes (Grupo F: fumantes; Grupo NF: não fumantes) submetidos a colecistectomias laparoscópicas sob anestesia geral foram avaliados. Os pacientes completaram o Teste para Dependência de Nicotina de Fagerstrom. Os níveis pré-operatórios de monóxido de carbono no ar expirado foram determinados usando o piCO + Smokerlyzer 12 h antes da cirurgia. As complicações respiratórias foram registradas durante a indução da anestesia, no intraoperatório, durante a extubação e na sala de recuperação. Resultados Aumentos estatisticamente significativos foram observados no Grupo F em relação à incidência de hipóxia durante a indução da anestesia, broncoespasmo intraoperatório, tratamento broncodilatador intraoperatório e broncoespasmo durante a extubação. O nível de monóxido de carbono no ar expirado, o Teste para Dependência de Nicotina de Fagerstrom e o número de cigarros fumados em 12 h no pré-operatório foram designados como covariáveis no modelo de regressão. A análise de regressão logística da indução anestésica mostrou que um aumento de uma unidade no nível de monóxido de carbono no ar expirado foi associado a um aumento de 1,16 vez do risco de hipóxia (OR = 1,16; IC de 95% 1,01-1,34; p = 0,038). A análise de regressão logística do período intraoperatório mostrou que um aumento de uma unidade no número de cigarros fumados em 12 h no pré-operatório foi associado a um aumento de 1,16 vez no risco de broncoespasmo (OR = 1,16; IC de 95% 1,04-1,30, p = 0,007). Enquanto na sala de recuperação, um aumento de uma unidade no escore do Teste para Dependência de Nicotina de Fagerstrom resultou em um aumento de 1,73 vez no risco de broncoespasmo (OR = 1,73; IC de 95% 1,04-2,88; p = 0,036). Conclusões O tabagismo mostrou aumentar a incidência de complicações respiratórias intraoperatórias sob anestesia geral. Além disso, o nível estimado de monóxido de carbono no ar expirado no pré-operatório pode servir como um indicador do risco em potencial de complicações respiratórias perioperatórias.

[Relationship between cigarette smoking and the carbon monoxide concentration in the exhaled breath with perioperative respiratory complications]. / Relação entre consumo de tabaco e concentração de monóxido de carbono na expiração com complicações respiratórias perioperatórias.

BACKGROUND: The purpose of the current study was to determine the effects of preoperative cigarette smoking and the carbon monoxide level in the exhaled breath on perioperative respiratory complications in patients undergoing elective laparoscopic cholecystectomies. METHODS: One hundred and fifty two patients (smokers, Group S and non-smokers, Group NS), who underwent laparoscopic cholecystectomies under general anesthesia, were studied. Patients completed the Fagerstrom Test for Nicotine Dependence. The preoperative carbon monoxide level in the exhaled breath levels were determined using the piCO+Smokerlyzer 12h before surgery. Respiratory complications were recorded during induction of anesthesia, intraoperatively, during extubation, and in the recovery room. RESULTS: Statistically significant increases were noted in group S with respect to the incidence of hypoxia during induction of anesthesia, intraoperative bronchospasm, bronchodilator treatment intraoperatively, and bronchospasm during extubation. The carbon monoxide level in the exhaled breath and the Fagerstrom Test for Nicotine Dependence, and number of cigarettes smoked 12h preoperatively were designated as covariates in the regression model. Logistic regression analysis of anesthetic induction showed that a 1 unit increase in the carbon monoxide level in the exhaled breath level was associated with a 1.16 fold increase in the risk of hypoxia (OR=1.16; 95% CI 1.01-1.34; p=0.038). Logistic regression analysis of the intraoperative course showed that a 1 unit increase in the number of cigarettes smoked 12h preoperatively was associated with a 1.16 fold increase in the risk of bronchospasm (OR=1.16; 95% CI 1.04-1.30; p=0.007). While in the recovery room, a 1 unit increase in the Fagerstrom Test for Nicotine Dependence score resulted in a 1.73 fold increase in the risk of bronchospasm (OR=1.73; 95% CI 1.04-2.88; p=0.036). CONCLUSIONS: Cigarette smoking was shown to increase the incidence of intraoperative respiratory complications while under general anesthesia. Moreover, the estimated preoperative carbon monoxide level in the exhaled breath level may serve as an indicator of the potential risk of perioperative respiratory complications.

The Effect of Different Intraabdominal Pressures on Thiol/Disulfide Homeostasis in Children Who Underwent Ambulatory Laparoscopic Surgery: A Prospective Randomized Study.

BACKGROUND: Thiol/disulfide homeostasis is a significant parameter in determining the oxidative stress response after ischemia and reperfusion. We aimed to investigate the effects of applying different intraabdominal pressure (IAP) on thiol/disulfide homeostasis, ischemia-modified albumin (IMA) levels, and hemodynamics in pediatric laparoscopic surgery. MATERIALS AND METHODS: Blood samples were collected from 36 pediatric patients who were planned to undergo laparoscopic surgery for nonpalpable testis or varicocele under general anesthesia, immediately after intubation as the baseline and 5 minutes after abdominal desufflation for determining the thiol/disulfide, and IMA levels. The patients were divided into two groups; group 1 received a pneumoperitoneum pressure of 8 mm Hg (n = 18), and group 2 received 12 mm Hg (n = 18). The clinical characteristics and thiol/disulfide homeostasis and IMA levels of the patients were compared. RESULTS: No difference was detected regarding the clinical features between the groups. The comparison after intubation and after desufflation in group 1 demonstrated lower native thiol (453 ± 67 versus 422 ± 57 µmol/L, P = .059) and total thiol (497 ± 73 versus 466 ± 62 µmol/L, P = .061) levels, which was statistically insignificant. The serum native thiol level was found lower than baseline in group 2 where a 12 mm Hg IAP was applied, this difference was not statistically significant (429 ± 47 versus 412 ± 53 µmol/L, P = .078). The comparison of serum IMA levels after desufflation with the baseline (0.505 ± 0.018 versus 0.632 ± 0.022) in group 2 was found statistically significantly high (P = .031). The comparison of the perioperative heart rate and SpO2 levels with before induction was found statistically insignificant. CONCLUSIONS: Neither of 8 nor 12 mm Hg IAPs in pediatric laparoscopic surgery caused any changes in novel indicators of thiol/disulfide homeostasis parameters; however, 12 mm Hg IAP increased the levels of IMA.

Effects of Different Anesthetic Agents on Surgical Site Hemorrhage During Circumcision.

PURPOSE: To investigate the effects of ketamine+midazolam and propofol+sevoflurane anesthesia on surgical site hemorrhage during circumcision procedures. MATERIALS AND METHODS: The boys undergoing circumcision surgery were included in the study. The patients were divided into two groups. In Group 1 (n = 50), 0.01 mg/kg midazolam and 2 mg/kg IV ketamine were administered. In Group 2 (n = 50), 1 ?g/kg fentanyl, 1 mg/kg lidocaine 2%, and 2-3 mg/kg IV propofol were administered, and patency of airway was ensured with a laryngeal mask airway. The intraoperative bleeding scale was recorded during the procedure to evaluate surgical site bleeding. Hemorrhage was checked for the first three hours using the postoperative bleeding scale to follow the amount of hemorrhage. RESULTS: Intraoperative bleeding scores were significantly higher in Group 1 as compared to Group 2. However, there was no significant difference between the groups regarding frequency of postoperative hemorrhage. Themean blood pressure values measured at 5th, 10th, 15th minutes and recovery room were significantly higher in Group 1. CONCLUSION: The intraoperative bleeding scores were significantly higher with ketamine+midazolam compared to propofol+sevoflurane. On the other hand this hemorrhage can be controlled easily with appropriate hemostasis, and the amount of blood loss was not clinically significant. We think that our study makes a positive contribution to the literature about the effects of anesthetics on the surgical site bleeding during circumcision. CLINICAL TRIALS REGISTRATION: ACTRN12616000189426.

Knowledge of the Research Assistants Regarding Local Anaesthetics and Toxicity.

OBJECTIVE: Cardiovascular system depression, respiratory arrest, coma, convulsions, loss of consciousness, muscle twitching, blurred vision, vertigo, dizziness and numbness of the tongue can be seen in local anaesthetic toxicity. Treatment includes 20% lipid solutions, airway control, symptomatic treatment for arrhythmia and convulsions. The aim of this study is to present the knowledge of research assistants, who used local anaesthetics in daily practice, regarding these medications and toxicity treatment and to raise awareness. METHODS: The questionnaire comprising 20 questions was administered to 115 research assistants who worked at different specialities in our hospital. RESULTS: One hundred and two (88.6%) research assistants answered the questionnaire. Participants' mean age was 28.93 years. Most of them were from the Emergency Department (15.7%). A total of 40.6% of participants worked for 2-5 years at their departments. Local anaesthetics were used in daily practice for 44.4% of them, but 70.3% of them had not been educated about local anaesthetics. Research assistants from anaesthesiology and reanimation participated at a significantly higher rate than other departments (76.9%), in terms of training programs regarding local anaesthetics. While the most popular answers about early toxicity symptoms were anaphylaxis (12.7%) and arrthymia (12.7%), late toxicity was hepatotoxicity (10.8%). However, 87.9% of participants had never encountered local anaesthetic toxicity. The great majority of participants had never heard of lipid therapy (67.4%), and those who were aware had heard it from their trainers (52.2%). Although lipid solution was available in our hospital, only 8.4% of participants knew this. CONCLUSION: We believe that additional training programs regarding local anaesthetics and toxicity are needed.