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Kanıta dayalı tıbbın en önem ilkesi; mevcut kanıtların değerlendirilmesi, en iyi kanıtlara ulaşılması ve bu kanıtlar doğrultusunda karar verilmesidir. Kanıta dayalı hemşirelik uygulamalarının temelini ise; hemşirelik alanındaki en iyi kanıtların üretilmesi, bu kanıtların klinik uzmanlık ve hasta tercihleri ile entegrasyonun sağlanarak hemşirelik bakımında kullanımı oluşturmaktadır. Bu kapsamda randomize kontrollü deneysel tasarımlar kanıtların üretilmesi ve hemşireleri klinik hemşirelik kararları konusunda bilgilendirilmesiyle doğrudan ilişkili ve vazgeçilemez konumdadır. Son yıllarda, hemşirelik alanında deneysel olarak tasarlanan ve yayınlanan çalışmaların sayısında artış görülmektedir. Ancak randomize kontrollü deneysel tasarımların metodolojisini, bulgularını eksiksiz, açık ve şeffaf bir şekilde sunulmasını sağlayan raporlama sistemlerinin kullanımıyla ilgili sınırlılıklar devam etmektedir. Bu nedenle randomize kontrollü çalışmaların raporlama standartlarını belirlemek, sistematik raporlama hatalarından kaçınmak için, hemşirelik araştırmalarının uluslararası geçerliliği olan kontrol listelerine göre raporlandırılması önemlidir. Bu derlemede, hemşirelik alanında randomize kontrollü çalışmaların Konsolide Raporlama Denemeleri Bildirimi (CONSORT) sistemine göre raporlanmasının önemini vurgulamak ve hemşirelik araştırmalarında non-farmakolojik CONSORT uzantısının kullanımı hakkında farkındalık oluşturmak amaçlanmıştır., The most crucial principle of evidence-based medicine; evaluating available evidence, obtaining the best evidence, and making a decision based on that evidence. The basis of evidence-based nursing practices; the production of the best available evidence in the field of nursing, the use of this evidence in nursing care by integrating with clinical expertise and patient preferences. In this context, randomized controlled experimental designs are directly related and indispensable for producing evidence and informing nurses about clinical nursing decisions. In recent years, there has been an increase in the number of experimentally designed and published studies in nursing. However, limitations remain regarding the use of reporting systems that provide a complete, open, and transparent presentation of randomized controlled experimental designs' methodology and findings. For this reason, it is crucial to report randomized controlled studies according to internationally validated checklists in nursing studies to determine reporting standards and to avoid systematic reporting errors. In this review, it is aimed to emphasize the importance of reporting randomized controlled studies in the field of nursing according to the Consolidated Standards of Reporting Trials system and to raise awareness about the use of the nonpharmacological CONSORT extension in nursing research.

Aim: The aim of the present study was to investigate the analgesic and anti-inflammatory efficacy of 0.25% flurbiprofen mouthwash, and to evaluate its effect on the parameters related to patient morbidity and early wound healing after periodontal flap surgery.Material and methods: Thirty-two patients (19 females and 13 males), diagnosed with moderate periodontitis and presenting at least one quadrant scheduled for periodontal flap surgery, were randomly allocated to either the flurbiprofen group or the placebo group. The plaque index (PI), gingival index (GI), probing pocket depth (PPD), bleeding on probing (BOP) and clinical attachment level (CAL) were evaluated at baseline and PI and GI were re-evaluated at 30-day follow-up. On postoperative 1, 3, 7, 14 and 30 days, postoperative pain, discomfort, changes in patientsÂ’ dietary habits, burning sensation and postoperative swelling were analyzed by using a visual analog scale (VAS). At postoperative 7 days, the early wound healing index was assessed clinically. Results: The mean VAS scores exhibiting postoperative pain were significantly lower in flurbiprofen group compared to placebo group at days 1, 7 and 30 (p

Giriş: Bir meslek üyesi olma yolunda üniversitede okuyan hemşirelik öğrencilerinde öfkeyi işlevsel düzenleyebilme konusu giderek önem kazanmaktadır. Öfkeyi düzenlemede bilişsel-davranışçı yaklaşımların ve müziğin bu yaş grubunda etkili araçlar olarak kullanılabildiği bilinmektedir. Müziğin ritim bileşeni ile duygusal düzenleme süreçlerini bilişsel-davranışçı bir temelde inceleyen Gross Duygu Düzenleme Modeli'nin bütünleştirilmesi ve psikiyatri hemşireliği uzmanlığında düzenli ve kolaylıkla ulaşabilecek yeni girişimsel araçların geliştirilmesi önemli görülmüştür. Araştırma sonuçları, müzikte ritim çalışmalarıyla bütünleştirilmiş Gross Duygu Düzenleme Modeli girişimlerinin öğrenci hemşirelerde işlevsel öfke düzenlenmesi için kullanımı açısından sonraki çalışmalara örnek olacaktır. Amaç: Araştırma, müzikte ritim bileşeninin Gross Duygu Düzenleme Modeli ile bütünleştirilerek yürütülecek öfke düzenleme programının, öfke duygusu açısından risk altında olduğu taramalarla belirlenen öğrenci hemşirelerde öfke ifadesi ve öfke tarzları üzerindeki etkisinin belirlenmesi amacıyla yürütülmüştür. Gereç ve yöntem: Araştırma üç kontrol gruplu ve tek körlü randomize deneysel tiptedir. E.Ü. Hemşirelik Fakültesi'nde okuyan ve Sürekli Öfke-Öfke İfadesi Tarzları Ölçeği (SÖÖİTÖ) ile Sürekli Öfke puanları ortalamanın üzerinde saptanan üçüncü sınıf öğrencileri araştırmanın hedef grubunu oluşturmuştur (N=67). Araştırma verileri örneklem koşullarını yerine getiren 38 öğrenciden sağlanmıştır. Veriler SÖÖİTÖ ve alanyazın doğrultusunda geliştirilen 'Kişisel Bilgi Formu' kullanılarak; ön-son ve izlem ölçümleriyle toplanmıştır. Müzikal ritim girişimleri ile bütünleştirilmiş Gross Duygu Düzenleme Modelli girişim programı, ön uygulama yapılmasının ardından beş oturumda tamamlanmıştır. Müzikal ritim girişimlerinin yer aldığı oturumlar bir uzmanla yürütülmüştür. Veri analizinde tek yönlü ve tekrarlı varyans analizleri (4x3 Faktöriyel Anova) kullanılmıştır. İstatistiksel önemlilik düzeyi p˂0.05, etki büyüklüğü ε2 ile değerlendirilmiştir. Araştırmanın etik izinleri alınmıştır. Bulgular: Araştırmada farklı zamanlardaki farklı girişimsel uygulamaların SÖÖİTÖ puanları üzerindeki etkisi incelendiğinde, Sürekli Öfke(F(6-68): 22,639, p, Introduction: Nursing students' anger regulation functionally has increasingly gained importance. It is known that cognitive behavioral approaches and music can be used as effective tools for young adults. It is important that the rhythm component of music be integrated with the Gross Model of Emotion Regulation, which analyzes the emotional regulation processes on a cognitive-behavioral basis, and new interventional tools be developed, which can be regularly and easily accessed in psychiatric nursing. The study results will shed light on future studies in terms of using the Gross Model, integrated in musical rhythm studies, to manage functional anger in student nurses. Aim: The study aims to determine the effect of the anger management program to be implemented by integrating the rhythm component of music with the Gross Model of Emotion Regulation on the anger expression and anger types of nursing students determined to be under risk through screenings. Materials and Methods: This single-blind randomized experimental research was conducted with three control groups. The study group consisted of third-grade students (N=67) who were enrolled in Ege University Faculty of Nursing and determined to have scores above average from The State-Trait Anger Expression Inventory (STAXI). The study data were collected from 38 students who met the inclusion criteria. They were collected with pre-post tests and follow-up measurements using STAXI and introductory information form developed in light of the literature. The Gross Model of Emotion Regulation intervention program, integrated with musical rhythms, was completed in five sessions after pilot study. The sessions in the musical rhythms were carried out in company with a specialist. The data were analyzed using one-way and two-way variance analyses (4x3 Factorial ANOVA). The statistical significance level was measured with p˂0.05, and effect size was measured with ε2. Ethical permissions were obtained to conduct the study. Results: Considering the effect of different intervention applications at different time periods on the STAXI scores, there were differences between groups in terms of Trait Anger (F(6-68): 22,639, p

Chronic pelvic pain (CPP) is defined as pain of at least 6 months' duration that occurs in the lower abdomen or below the umbilicus and has resulted in functional or psychological disability, and required intervention and treatment. Therapeutic interventions center around the treatment of CPP as a diagnosis in and of itself, and treatment of specific disorders that may be related to CPP. A multidisciplinary approach for diagnosis and treatment seems to be most effective for symptomatic relief. The evidence for such interventions as psychological treatments including the use of complementary and alternative medicine techniques for CPP treatment is reviewed in this study. Unfortunately, finding the best evidence in this setting is difficult as very few randomized controlled trials are available. A combination of treatments is usually required over time for the treatment of refractory CPP. The multifactorial nature of CPP needs to be discussed with the patient and a good rapport as well as a partnership needs to be developed to plan a management program with regular follow up. Promotion of a multidisciplinary approach which includes complementary and alternative medicine techniques in managing CPP in women seems to yield the best results., Kronik pelvik ağrı (KPA) en az 6 ay süren, alt karın bölgesinde veya umbilikusun altında yerleşen fonksiyonel veya psikolojik hastalığa neden olabilen, değerlendirme ve tedavi gerektiren bir ağrıdır. Tedaviye yönelik girişimler, bir tanı olarak KPA tedavisi ve KPA ile ilişkili belli başlı hastalıkların tedavisi etrafında yoğunlaşır. Semptomatik rahatlama için tanı ve tedavide multidisipliner bir yaklaşımın en etkilisi olduğu görülmektedir. Bu çalışmada KPA tedavisinde, tamamlayıcı ve alternatif tıp tekniklerinin de kullanıldığı psikolojik tedavi gibi girişimlerin kanıtları gözden geçirilmiştir. Maalesef bu konuda yapılmış çok az randomize kontrollü çalışma olduğundan en iyi kanıtı bulmak çok zordur. Refrakter KPA tedavisi için zaman geçtikçe bir tedavi kombinasyonuna ihtiyaç duyulmaktadır. KPA’nın multifaktöriyel doğası hastayla tartışmayı, onunla iyi bir uyum içinde bir partner kadar yakın olmayı ve düzenli takip edilecek bir yönetim planı geliştirmeyi gerektirir. Kadınlarda KPA yönetiminde tamamlayıcı ve alternatif tıp tekniklerinin de dahil olduğu multidisipliner bir yaklaşımı teşvik etmek en iyi sonuçları doğuracak gibi görünmektedir.

The prevalance of cardiovascular disease increases with age and cardiovascular disease is the leading cause of death in adults >75 years of age. However many trials have excluded older patients. So we don't have randomized trials but only limited subgroup analysis or registries for older patients. In general the indications for intervention and revascularization are not different in elderly patients. But complex co-morbidities, significant physical or cognitive disabilities can change our decision. Complex Coronary anatomy and the complications of the procedure is high in older patients. Long term mortality is similar in patients treated with Coronary artery bypass graft surgery or percutaneous coronary intervention, but re-intervention is higher in coronary intervention group. Invazive approach is superior to conservative treatment even in very elderly patients with acute coronary syndrome. We need randomized trials including mainly older patients in this era.

Randomised controlled trials (RCT) are considered as gold standart for clinical studies because of their standart protocols, well-defined case and control groups, and their statistical methods for pre-defined outcomes. Real-world studies (RWS) are generally performed to evaluate and/or obtain long term efficacy and safety data of a particular drug-intervention or application in populations who were not included in RCT for various resons or in real world settings such as routine health care systems. As RWS give the opportunity for comparisons which do not exist in the original protocols of RCT; currently they have been the choice of research method in the clinical drug investigations. Increasing use of non-vitamin K antagonist oral anticoagulants (NOAC) in routine clinical practice and their efficacy and safety data coming from RCT have been supported by the data and evidences obtained from the real world studies. In this article; following a brief evaluation of advantage and limitations of RWS, some real world data and evidences about rivaroxaban using various study designs such as non-interventional observations, registries and database analysis will be reviewed and summarized.

*****Department of Pediatrics, Midnapore Medical College, Midnapore, West Bengal, India Objective: Post herpetic neuralgia is a most common complication of herpes zoster which is difficult to treat. Significant beneficial effects found when treated with antiviral, tricyclic antidepressant, anticonvulsive like gabapentine and pregabalin, opioid and non opioid analgesic etc. Primary prevention can also be done with vaccine. The aim of this randomized comparative study was to establish clinical efficacy with amitriptyline and pregabalin. Methods: An open ended randomized clinical trial was conducted to compared clinical efficacy of amitriptyline (n=25) and pregabalin (n=25). Amitriptyline was given 25 mg once daily and pregabalin 75 mg twice daily. Total period of treatment were 6 month and patients were reviewed at the end of 2 months, 4 months and 6 months to evaluate the degree of improvement in pain perception and any adverse reaction. Results: Four types of patients were included in this study and among them thoracic type was the commonest (54%). It was followed by cervical (24%), trigeminal (16%) and lumbosacral types (6%). According to VAS score, satisfactory significant improvements in pain perception was observed at the end of 2 months (36%vs 8%, p

WOS: 000352482000027 PubMed: 26084138 Background/aim: To compare the postoperative analgesic efficacy and side effects of paracetamol and tramadol in patients undergoing lumbar disc surgery. Materials and methods: Group P (paracetamol group) was given 1 g of paracetamol intravenously 30 min before the end of the operation and 1 g each day at 6-h intervals. Group T (tramadol group) was given 1.5 mg/kg of tramadol as a loading dose and patient-controlled analgesia for 1 day. Hemodynamic parameters, modified Aldrete score, Ramsay sedation scale score, patient satisfaction scale (PSS) score, visual analog scale (VAS) score, nausea/vomiting scale score, and additional analgesic needs/times were recorded. Results: PSS scores were significantly higher in Group T (P < 0.05). The total analgesic consumption was significantly higher in Group P. There were no significant differences in the VAS scores at any time points. Twenty-one patients in Group P and 8 patients in Group T needed additional analgesia (P < 0.05). The first additional analgesic time was earlier in Group P, and pain was more evident at the 15th minute and at hours 2 and 6 (P < 0.05). Conclusion: Paracetamol alone was not able to provide effective analgesia. Tramadol was more effective in the treatment of postoperative pain after lumbar disc surgery.

To evaluate the effects of different intracorporeal ligation techniques with titanium clips, Plasma Trisector (Gyrus, USA) (PTG), and surgical silk on bilateral laparoscopic varicocelectomy (LPVx). Materials and methods: Between May 2009 and August 2012, 100 patients who underwent bilateral LPVx were evaluated. The demographic parameters of patients, preoperative radiological findings, semen analysis, operative data, and follow-up were recorded. All of the patients were divided into 3 groups, randomized prospectively. The patients whose veins were ligated by 5-mm titanium clips were included in group I, those whose veins were ligated by PTG were included in group II, and those whose veins were ligated by surgical silk were included in group III. The recorded data of the groups were analyzed. Results: Mean follow-up time was 18.8 ± 1.1 months. According to the demographics of age, body mass index, spermiogram, and diameter of veins before surgery, there were no statistical differences between any of the groups (P > 0.05). However, operation time was longer in group III (P < 0.0001), while total numbers of ligated veins did not differ among the groups (P > 0.05). Additionally, hospital stay, oral intake, and complications were not different among the groups (P > 0.05). In follow-up the sperm count analysis was higher than the preoperative count analysis for all of the groups (P < 0.05). Conclusion: PTG may provide a shorter operation time than using titanium clips and/or surgical silk in LPVx. Additionally, PTG may increase sperm count with fewer complications than the other ligation techniques in LPVx. Therefore, PTG may be the new candidate electrosurgical standard device for LPVx in the nearby future.

Objective: Postoperative cognitive dysfunction (POCD) is a decrease on mental and memorial process that provides individual information and solving the problems. We aimed to review the effect of intraoperative mean blood pressure (MBP) on development of in geriatric patients diagnosed with hypertension. Material and Metod: Patients older than 65 years old, diagnosed with an American Society of Anesthesiologist (ASA) physical condition II-III and underwent elective surgery that continued at least one hour were included this prospective, randomized and double blinded study conducted between March 2012-October 2012. The patients were divided into two groups (Group H, diagnosed as hypertension; Group K, normotension). 1.5-2 mg kg-1 propofol and 0.08-0.1 mg kg-1 vecuronium were applied at anesthesia induction and desflurane and 0.1 mcg kg-1 min-1 remifentanil at anesthesia maintain. Intraoperative MBP was stabilized at limits ±20% of control measure and was recorded on minute 5, 15, 30, 45, 60, 90 and 120. Neuropsychological tests were applied preoperatively and repeated at postoperative day 1 and month 1. Results: 90 patients were included in the study but 81 of them (40 in Group H; 41 in Group K) completed. Preoperative MBPs were higher in Group H (110±15 vs 104±13, p0.05) at postoperative day 1 and as 15% in Group H and 19.5% Group K (6/40 vs 8/41, p>0.05). No correlation was found between POCD and values of MBPs. Conclusion: We conclude that intraoperative MBP is not a risk factor for development of POCD at short and intermediate period in non-cardiac geriatric surgical patients, when it was maintained within±20% compared to to preoperative control values. © 2015, Nobelmedicus. All Rights Reserved.

Objective In this study, the effects of radiation emitted from mobile phone (MP) on heart rate variability (HRV) which is accepted a non-invasive indicator of autonomic nervous system (ANS) were investigated with considering the deficiency of previous studies. Methods A randomized controlled study has been designed and utilized with 30 young and healthy volunteers. During the experiment that had three periods, the electrocardiogram (ECG) and respiration signals were recorded and MP was attached to subjects' right ear with a bone. Ten subjects selected randomly were exposed to high -level radiation during the second period (Experimental Group 1). Ten of others were exposed during the third period with maximum level radiation (Experimental Group 2). Ten records were also made while MP was closed as a control. Short -term HRV parameters were obtained and repeated measures ANOVA and suitable post-hoc tests applied to the results. Results According to the results of the repeated measures ANOVA; there were no significant main effects of groups. However, there were some significant differences in measuring time periods and groups*period interactions. The post-hoc tests showed that mean R to R interval and HF power are significantly changed by maximum radiation emitted from MP. Conclusion Due to the radiation emitted from MPs at maximum power, some changes may occur in HRV parameters that are associated with increased parasympathetic activity. But, the level of these changes is similar to daily activities as excitement, and stand up.

WOS: 000264851900013, Objective: In many clinical and experimental trials, researchers assess the effect of treatment by measuring the value of a continuous variable before and after the treatment. If there is an imbalance in baseline values between groups, some statistical comparisons may result with mistakes in estimation of the treatment effect. The aim of this study was to explain which statistical methods were more suitable in the estimation of the treatment effect when there was an imbalance for the baseline values between groups. Material and Methods: Different statistical methods, which are used in estimation of treatment effects, were briefly explained and were applied to a hypothetical data set, which had significant differences between groups according to baseline values of the related variable. In addition, a limited simulation study for several conditions was carried out to determine suitable statistical methods. Results: Baseline values were different between two groups and correlation was low between baseline and follow up values of related variable in each group for hypothetical data set. In this condition, comparison of simple differences between baseline and follow up values was the best method for the estimation of treatment effect. In the simulation study, the power of the test for simple differences was higher (85%) than the value in the analysis of covariance (40%) when correlations were low and sample sizes were small in each group. Moreover, the powers of these two tests were high and similar to each other, when sample sizes were moderate. When the correlation was high, the powers of both tests were high in both small and moderate sample sizes. Conclusion: The presence of a significant difference should be sought between groups according to baseline values of the related variable even though groups are randomly assigned. In addition, the degree of the correlation between baseline and follow up values should be taken into consideration. When significant differences exist between baseline values and the correlation is low, we suggest that the classical methods should be used to determine the significance of the effect; however, when the correlation is high, covariance analysis is a suitable method.

Objective: In many clinical and experimental trials, researchers assess the effect of treatment by measuring the value of a continuous variable before and after the treatment. If there is an imbalance in baseline values between groups, some statistical comparisons may result with mistakes in estimation of the treatment effect. The aim of this study was to explain which statistical methods were more suitable in the estimation of the treatment effect when there was an imbalance for the baseline values between groups. Material and Methods: Different statistical methods, which are used in estimation of treatment effects, were briefly explained and were applied to a hypothetical data set, which had significant differences between groups according to baseline values of the related variable. In addition, a limited simulation study for several conditions was carried out to determine suitable statistical methods. Results: Baseline values were different between two groups and correlation was low between baseline and follow up values of related variable in each group for hypothetical data set. In this condition, comparison of simple differences between baseline and follow up values was the best method for the estimation of treatment effect. In the simulation study, the power of the test for simple differences was higher (85%) than the value in the analysis of covariance (40%) when correlations were low and sample sizes were small in each group. Moreover, the powers of these two tests were high and similar to each other, when sample sizes were moderate. When the correlation was high, the powers of both tests were high in both small and moderate sample sizes. Conclusion: The presence of a significant difference should be sought between groups according to baseline values of the related variable even though groups are randomly assigned. In addition, the degree of the correlation between baseline and follow up values should be taken into consideration. When significant differences exist between baseline values and the correlation is low, we suggest that the classical methods should be used to determine the significance of the effect; however, when the correlation is high, covariance analysis is a suitable method. Copyright © 2009 by Türkiye Klinikleri.

Objective: Electroconvulsive therapy (ECT) has a prominent place in current psychiatry. One of the most common side effects of this therapy is headache. In this study, it was aimed to evaluate the effects of naproxen sodium given prior to ECT on headache and treatment satisfaction. Methods: The study was designed as prospective, randomized and blind. Twenty patients received 550 mg of naproxen sodium 90 minutes before the first and second ECT sessions while the patients in the control group received placebo (powdered glucose). Visual Analog Scale (VAS) was applied 30 minutes after the session and Treatment Satisfaction Scale was applied at the end of treatment. Results: The frequency of headache in the placebo group was significantly higher than that of the naproxen-treated (p

Surgical trauma increases postoperative pain and its duration by producing nociceptive sensitization. This sensitization can be prevented by preemptive analgesia and the result is decrease in postoperative pain. The effectiveness of piroxicam that is used for preemptive analgesia has been investigated in this randomized, double-blind, placebo controlled study. Sixty patients undergoing elective laparotomy were randomly allocated into three groups. Group I (n=20) were given piroxicam 40 mg, IM the night before the operation, Group II (n=20) were given piroxicam 40 mg, IM at the end of the operation and Group III were given 2 mLs of saline solution as placebo by IM route the night before the operation. Postoperative analgesia was provided by meperidine through epidural catheter with PCA device. Visual Analog Scores (VAS), total meperidine dosages and opioid side effects were recorded hourly and evaluated in the first 24 hours following operation. VAS values on 0,1,2,3,4,8,12 and 24 th hours and total meperidine doses on 4,8,12,24th hours were significantly differed between groups I and III. VAS values on 4,8,12 and 24th hours and total meperidine doses on 8,12 and 24th hours differed significantly between groups II and III. As a result it has been concluded that piroxicam which is used for preemptive analgesia in elective abdominal surgery is an effective drug with better VAS scores and less opioid demand in postoperative period.

The aim of this study was to investigate the effect of oral clonidine on the duration and level of spinal anaesthesia with bupivacaine. After obtaining approval from local ethical committee, we studied 30 ASA I class patients, that were randomly divided into two equal groups. The patients of clonidine group received 150 μg clonidine orally 90 minutes before spinal anaesthesia while the control group did not receive any premedication. Three mililiters of 0.5 % hyperbaric bupivacaine was given to all patients through L3-4 interspace for spinal anaesthesia. The onset time and duration of sensory block at T10 level were evaluated with pinprick test; the onset and resolution of grade 4 motor block with bromage scale. Heart rate, blood pressure and SpO2 were recorded. There weren't any difference between the two groups with respect to the onset time and the level of sensory and motor block, but the duration of sensory and motor block were longer in clonidine group (p

The purpose of our study was to assess sevoflurane for inhalational rapid induction compared with halothane. 40 ASA I-II unpremedicated patients aged between 2168 years and planned elective operation, were randomly divided into two equal groups. Vital capacity breathing was reached to the patients and inhalational rapid induction was administrated with 8 % sevoflurane or 4 % halothane in 66 % nitrous oxide and 33 % oxygen. Time to loss of eyelash reflex, breathing frequency until loss of eyelash reflex and airway complications observed, were recorded. Blood pressure, heart rate, peripheral O2 saturation and end tidal CO2 were measured at certain interval. The patients were asked their impressions about the method in postanaesthetic period. Time to loss of eyelash reflex were found to be 44.3±13 and 64.6±16 seconds, and breathing frequency until loss of eyelash were found 4.5±2.8 and 8.2±2.8 for sevoflurane and halothane respectively. Time (p

The aim of this study is to investigate the effects of inhalation anaesthesia (with isoflurane) and total intravenous anaesthesia (TIVA) (with propofol) on heart rate, arterial pressure and oxygen saturation in laparoscopic cholecystectomy. Fourty ASA I-II-III patients aged 23 to 80 years were included in this study. The patients were divided randomly into two equal groups. Inhalation anaesthesia group received 66% N20 + 33% O2 + 1-1.5% isoflurane and the TIVA group received propofol infusion respectively at the first 15 min 10 mg/kg/h, at the next 15 min 8 mg/kg/h; then until 10 min before the end of the operation 6 mg/kg/h. Heart rates, arterial pressures and oxygen saturations were measured at the beginning, after induction, intubation, insufflation, positioning, exsufflation and return to the horizontal position; intraoperatively and at the end of the anaesthesia at 5th, 15th, 30th, 45th and 60th minutes. The cardiac rhythm recorded by ECG. There were no statistically significant differences between two groups in heart rate, arterial pressures and cardiac rhythm (p>0.05). In inhalation group at the 5th minutes of operation systolic arterial pressures increased with respect to the time after the insufflation (p

In this study we aimed to compare propofol-N2O anaesthesia and thiopentone-halothane-N2O anaesthesia. Sixty patients from ASA II-III-IV aged between 58-76 yr who undergo urological operations were taken into the study. Patients were divided randomly into two equal groups. In the first group 2 mg/kg propofol and 0.1 mg/kg vecuronium were given for induction and intubation. Anaesthesia maintenance was supplied with propofol infusion, in the first 30 minutes 10 mg/kg/h, in the second 30 minutes 5 mg/kg/h and 10 minutes before the end of the operation 2.5 mg/kg/h. In the second group, 5-6 mg/kg thiopentone and 0.1 mg/kg vecuronium were given for induction and intubation. Anaesthesia maintenance was supplied with 50% N2O+50% O2+1% halothane. Control, and intra-operative arterial pressures, heart rate and SaO2 were noted every 15 minutes. Times to awakening and orientation were determined. There were no statistically significant differences between arterial pressures, heart rate and SaO2 among groups (p > 0.05). Awakening and orientation time were earlier in the first group (5.3 ± 2.5 min and 6.4 ± 3.1 min) comparing to the second (10.4 ± 2.2 min and 11.6 ± 1.9 min), (p < 0.001 and p < 0.001). Regarding arterial pressures, heart rate and SaO2 differences both anaesthesia techniques were of equal quality but recovery was found better in the propofol + N2O anaesthesia group.

It is still controversial whether the use of calcium channel blockers in cardioplegic solutions decreases ischemic and reperfusion damage. In this study, the effect of diltiazem addition to cold blood potassium cardioplegia in the induction phase on myocardial protection was investigated. A prospective, randomized trial was instituted to evaluate the hemodynamic and myocardial metabolic recovery in 20 patients undergoing elective aortocoronary bypass with either diltiazem in cold blood potassium cardioplegia (diltiazem group, n=10) or cold blood potassium cardioplegia (control group, n=10). In the diltiazem group, 150 mg/kg diltiazem was added to the cardioplegic solution in the induction phase of cardioplegia. In all cases, blood samples for measurement of lactate level and calculation of lactate extraction were taken from coronary sinus and radial artery at the beginning and the 30th minute of reperfusion period. CK-MB levels were measured in the intensive care at postoperative 6th and 18th hours. The hemodynamic findings of both diltiazem and control groups were compared in the preoperative and early postoperative periods. Lactate production was significantly lower in the diltiazem group at the beginning of the reperfusion period (p0.05). CK-MB level was significantly higher in the control group in the postoperative period. Similar hemodynamic findings were obtained in both groups in the preoperative and the early postoperative periods. We concluded that diltiazem addition to cold blood potassium cardioplegia decreases ischemic and reperfusion damage and has a beneficial effect on myocardial protection.

Postoperative analgesia that was provided by extradural administration of morphine, fentanyl or i.m. dipyron in 52 patients was discussed in a randomized study. Patients were randomly assigned into three groups to receive either extradural morphine (4 mg), fentanyl (100 mg) or intramuscular dipyron (1 g). Morphine (4 mg) in 10 ml saline solution was used in group I (19 patients), fentanyl (100 mg) in group II (19 patients) and dipyron (i.m. 1 g) in group III (14 patients). Pain and sedation analogue score, side effects, cardiovascular and respiratory effects, quality and duration of pain relief were recorded. The analogue pain scores were decreased significantly by morphine and fentanyl (p0.05). The duration of analgesia with morphine, fentanyl and dipyron were respectively 19, 2.1 and 3.7 hours. The quality of pain relief was better by morphine and side effects were neglectible.