Search

In this study, we aimed to evaluate the effects of different agents used for anesthesia maintenance on liver enzymes and lactate changes in patients undergoing laparoscopic cholecystectomy using CO2 pneumoperitoneum with constant pressure. Seventy-five patients planned to undergo laparoscopic cholecystectomy operation have been randomly divided into 3 groups. Liver function tests have been evaluated preoperatively and postoperatively in the 24th hour. Arterial blood samples for lactate level determination were obtained: (T_1) immediately before pneumoperitoneum, (T_2) 10 min after pneumoperitoneum, (T_3) 30 min after pneumoperitoneum, (T_4) 60 min after desufflation of CO2. Patients scheduled to undergo laparoscopic cholecystectomy operation. The possible effects of different agents used for anesthesia maintenance on liver enzymes and lactate changes in patients undergoing laparoscopic cholecystectomy. In comparison of lactate values, there were no differences between the three groups in T_1, T_2 and T_4 measurements (P=0.059, P=0.108, P=0.225). However, in the T_3 measurements, lactate values are lower in the Group P, compared to Group S and D (P=0.001, P=0.001). Postoperative AST and ALT values are lower in the Group P, compared to Group S and D (P [Med-Science 2019; 8(1.000): 180-5]

Previous studies have shown that intensive care units (ICU) are among the most aggressive, tense and traumatic environments in the hospital. Intensive care units can cause physical and mental frazzle and damage in health care workers as much as they are for patients. In this study, it was aimed to evaluate depression and quality of life in ICU nurses in a tertiary care hospital. One hundred twenty ICU nurses, working more than 2 years in second and tertiary adult intensive care units, was included. The SF-36 Quality of Life Scale was used to assess the quality of life. The Beck Depression Inventory (BDI) was used to assess depression. The demographic data of the participants were also questioned through a separate form. The average age of nurses involved in the study (SS) 31.29 (5.23) and 65% female, 70% married, , 63% have children, and 31% were smokers. There was no statistically significant difference in the quality of life and depression scale scores of the participants according to age, gender, marital status, child ownership status, duration of intensive care study and smoking (p> 0.05). In conclusion, sociodemographic characteristics such as age, gender, marital status, having children, duration of intensive care study and smoking did not affect the quality of life and depression level of intensive care nurses working in a tertiary hospital. [Med-Science 2018; 7(1.000): 101-105]

The clinical picture of ethanol intoxication can present a broad range of signs and symptoms, from mild perception disorders to cardiac arrest and death. Although ethanol intoxication is a common condition, it is reported in literature here for the first time in a patient treated percutaneously for a hydatid cyst of the liver. The case was additionally complex given the fact that the patient was in the first trimester of pregnancy. Presented here is a case of ethanol intoxication in a 13-week pregnant woman who was treated percutaneously using 800 ml of ethanol for a hydatid cyst in the liver. [Med-Science 2016; 5(1.000): 296-300]

Huntington Chorea is central nervues system disease that is inherited autosomal dominantly which causes miscellaneous difficulties and has features by the aspect of anesthesia management. It was aimed to present the administiration of high dose sugammadex firstly, and secondly high dose sugammadex administiration in a Huntington Chorea case. [Med-Science 2016; 5(1.000): 301-5]

Number of transplantations increase every day, and thus anaesthetists encounter patients who were transplanted after transplantation more often. Like liver transplant, immunosuppression and various anaesthetic problems are important for patients after other transplantations, too. This article presents our infraclavicular block experience along with literature in a case with a patient who has Behcet\s disease, an immunosuppressive disease, and was transplanted with a liver. [Cukurova Med J 2014; 39(3.000): 658-661]

Background Changes in tissue oxygen saturation determined by near-infrared spectroscopy (NIRS) may help predict and determine the success of a lateral infraclavicular (LIC) block. We investigated whether evaluation of tissue oxygen saturation determined by NIRS could be an indicator of LIC block success. Methods Forty patients scheduled for hand or forearm surgery under LIC block were studied. NIRS sensors were placed on the ventral aspect of both mid-forearms, and the contralateral hand was used as the control group. NIRS values were recorded before the block and at regular intervals during the following 30 min. Results NIRS values were significantly higher in the successfully blocked patients when compared to the complete failure, partial failure, and contralateral hand groups at the 10th min. In the successfully blocked patients, NIRS values (mean ± SD [change in %]) increased by 11.09 ± 4.86 (16.03%), 15.00 ± 4.53 (21.76%), 16.35 ± 5.14 (23.77%), 16.38 ± 4.88 (23.85%), 16.67 ± 5.04 (24.29%), and 16.96 ± 5.71 (24.78%), respectively, from baseline to 5, 10, 15, 20, 25, and 30 min. ΔTs values were significantly higher in the successfully blocked patients than in the complete failure patients and contralateral hand at the 30th min. However, there was no statistically significant difference when comparing ΔTs values of successful block and partial failure block patients at the 30th min. Conclusions We conclude that measurement of tissue oxygen saturation by NIRS within the scope of evaluation of the lateral infraclavicular block is a rapid, effective, and applicable technique.

ÖZET Amaç: Çalışmamızda; hasta yakınlarının beyin ölümüne bakışları, buna paralel olarak organ bağışı konusu ve hastadan yaşam desteğini kesme konularında verdikleri kararların incelenmesi amaçlanmıştır. Materyal ve Metod: Selçuk Üniversitesi Tıp Fakültesi Hastanesinde 2017- 2019 yılları arasındaki beyin ölümü tanısı almış vakaların arşiv kayıtları taranarak yaş, cinsiyet, medeni durum, eğitim düzeyi, ikamet yeri gibi sosyo demografik özellikler kaydedildi. Arşiv kayıtlarından organ nakli izni verilen, aile isteği ile yaşam desteği kesilen, kendiliğinden kalp durması beklenen ve beyin ölümü deklerasyonu yapıldığı sırada kalbin durması şeklinde hasta yakını davranışları sınıflandırılarak yıllara göre vaka sayıları kaydedildi. Bulgular : Çalışmamız da arşiv taraması sonucunda toplamda 60 beyin ölümü tanısı konulmuştur. Hastaların yaş ortalaması 31.12 (std;24.7) dir. Erkek cinsiyet 37 (%61.7) kadın cinsiyet 23 (%38,3) olup erkeklerin oranı kadınlara göre daha yüksektir. Hasta yakını davranışlarında ise yaşam desteğinin kesilmesi en yüksek (%40) tercihtir. Bunu kalbin kendiliğinden durmasını bekleme (%38.3) ve organ bağışı (%18.3) takip etmektedir. Asıl dikkat çeken konu ise 2017-2019 yıllarında yaşam desteğinin kesilmesi kararını verenlerin oranı yüzde 20’den yüzde 50’ye çıkar iken, organ bağışı ise yüzde 25’den yüzde 10’a düşmüştür. Hasta yakını davranışları ile değişkenlerin Ki-kare analizinde hiçbir anlamlı bir ilişki bulunamamıştır. Sonuç : Hasta yakınlarının beyin ölümünü giderek daha fazla gerçek ölüm olarak kabullendiklerini ancak bu durumun organ bağışına (nakil iznine) yansımaması ise halen önemli sorun olarak karşımıza çıkmaktadır.

Abamektin intoksikasyonu nadir fakat alınan miktara bağlı olarak ölüme kadar gidebilen bir durumdur. Bizim olgumuzda 38 yaşındaki bir erkek özkıyım amaçlı 200 ml abamektin (18g/L) içerek intoksikasyon gerçekleşmiştir. Yoğun bakıma kabulünde şuuru kapalı ve Glaskow Koma Skalası Skoru 7 olan hasta nörolojik bulguları dışında herhangi bir abamektin intoksikasyonu ile ilgili bir kliniği söz konusu değildi. Uygulanan yoğun destek tedavisi ile birlikte yoğun bakıma kabulünün 12. saatinde anlamsız sesler çıkarmaya gözlerini spontan açmaya başlayan hastanın yoğun bakımdaki 2. gününde ise nörolojik durumu tamamen normale döndü. Yoğun bakım takiplerinde herhangi bir anormallik olmaması üzerine 3. günün sonunda servise devredildi. Abamektin intoksikasyonunda dikkatli bir destekleyici tedavi ile başarılı sonuçlar alınabilmektedir.

Lujan-Fryns sendromu 1979 yılında Fryns tarafından tanımlanan otozomal resesif geçiş gösteren multipl konjenital anomali ile karakterize bir sendromdur. Dismorfik yüz hatları, yarık damak, diyafragma hernisi gibi anestezi pratiğini etkileyebilecek bir çok anomali içeren nadir bir sendromdur. Anestezi ve/veya ameliyathane dışı anestezi yönetimi ile ilgili literatür bilgisi sınırlıdır. Burada Lujan-Fryns sendromlu bir olguda ameliyathane dışı anestezi yönetimini literatür eşliğinde sunmayı amaçladık.

Organ nakil sayıları her geçen gün artmakta olup bu durum anestezistlerin nakil olan hastalar ile nakil sonrası daha sık karşılaşmasına neden olmaktadır. Karaciğer naklinde olduğu şekilde diğer nakiller sonrasında da immünsüpresyon ve çeşitli anestezik problemler hastalar için önem taşımaktadır. Bu makalede immünsüpresif bir hastalık olan Behçet hastalığı ve karaciğer nakli olmuş bir olguda infraklaviküler blok deneyimimiz literatür eşliğinde sunulmuştur.

ABSTRACT BACKGROUND: Bispectral index (BIS) monitoring can positively affect cognitive performance through decreasing the use of sedative agents. We aimed to evaluate the effect of BIS monitoring on early cognitive performance among patients undergoing sedation for colonoscopy. DESIGN AND SETTING: Randomized, controlled trial in a university hospital. METHODS: 100 patients were randomized into two groups. In the monitored group (n = 50), the depth of anesthesia was monitored using the BIS, and BIS scores were maintained between 60 and 80. In the usual care group (n = 50), BIS monitoring was not performed. To determine the patients’ baseline cognitive performance levels, the mini-mental state examination (MMSE), Trieger dot test (TDT) and clock drawing test (CDT) were used. The patients’ post-procedure cognitive performance levels were determined when they were classified as ready for discharge. RESULTS: The total volume (mg) of propofol used [median (range) IQR] in the sedation procedure was lower in the monitored group [100 (50-200) 100-140] than in the usual care group [150 (75-200) 100-200] (P < 0.001). The discharge scores [mean (SD)] using MMSE and CDT were higher in the monitored group [26 (3) and 3 (1), respectively] than in the usual care group [23 (3) and 2 (1), respectively] (P = 0.002 and P = 0.002, respectively). The discharge scores using TDT [mean (SD)] were lower in the monitored group [11 (7)] than in the usual care group [15 (11)] (P = 0.033). CONCLUSION: BIS monitoring among sedated patients was associated with lower propofol use and smaller decline in cognitive performance. CLINICAL TRIAL REGISTRATION: This trial was registered in the Australian New Zealand Clinical Trial Registry (ACTRN12617000134325).