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The aim of this prospective, randomized, and double-blinded study was to compare the effects of desflurane, sevoflurane, propofol on both atrial and ventricular wall function by measurement of QT dispersion (QTd), corrected QT dispersion (QTcd), and P dispersion (Pd) on electrocardiogram (ECG). Forty-six patients from the American Society of Anesthesiologists class I−II undergoing noncardiac surgery, were enrolled in this study. Patients were randomly allocated to receive desflurane, sevoflurane or propofol anesthesia. ECG recordings were taken before and after 5 minutes of drug administration. Induction with desflurane significantly increased the QTd compared to baseline (38 ± 2 ms vs. 62 ± 6 ms, P < 0.05). Sevoflurane and propofol anesthesia was not associated with any changes in QTd. QTcd was increased with desflurane induction and decreased with sevoflurane and propofol induction, but this decrease was only significant in the propofol group (67 ± 5 ms vs. 45 ± 3 ms, P < 0.05). Pd was significantly increased after induction with desflurane (34 ± 3 vs. 63 ± 6 ms, P < 0.05). There was a significant increase in QTd and Pd in desflurane group, but this increment did not cause any dangerous arrhythmias. QTcd significantly decreased in propofol group. We believe that further investigations are required for using desflurane as safe as sevoflurane and propofol in noncardiac surgery patients who have high cardiac arrhythmia and ischemia risk.

Objective: Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) has caused a global pandemic with more than 664 million confirmed cases and more than 6.7 million deaths worldwide. In pandemic, several studies have been done about the relationship of some biochemical and hematological parameters with COVID 19 in order to assist diagnosis and treatment. However, a lot of information is not completely complete and there are contradictions in the data. In the present study, it was focused to compare the biochemical parameters of patients and healthy individuals due to COVID 19 by investigating the relationship between age and gender. Methods: The 317 individuals who consulted to the Pandemic Outpatient Clinic with the suspicion of COVID 19 between February 2022 and November 2022 were evaluated by laboratory tests. In present study, biochemical parameter values of individuals with positive and negative COVID 19 test outcomes were used as material. These biochemical parameters were compared statistically based on different age ranges and gender groups. Results: It was ascertained that the values such as urea (UREA), creatine (KREA), ferritin (FER), aspartate transaminase (AST), alanine transaminase (ALT), high sensitivity troponin I (HSTI), creatine kinase (CK) and C reactive protein (CRP) in male patients with COVID 19 were higher than female patients with COVID 19. Moreover, it was detected that there was a statistically significant increase in parameters such as GLU, FER, AST, lactate dehydrogenase (LDH), HSTI, CK and CRP in COVID 19 patients aged 18-65 years. Conclusions: Many biomarkers of prognostic importance are expensive, ordinary and pricey-effective biomarkers such as FER, AST, LDH, HSTI, CK and CRP can be used to monitor disease in patients with COVID 19 infection. [ABSTRACT FROM AUTHOR]

Introduction: In this study, we evaluated patient response and haemodynamic parameters in patients with low ejection fraction undergoing coronary bypass surgery with either fentanil or remifentanil in conjunction with etomidate., Material and Methods: We evaluated 30 cases of coronary artery surgery, which were divided into two treatment groups ( n = 15 each). In group F (fentanil group), the following regimen was employed for anaesthesia induction: 1 mg/kg lidocaine, 0.3 mg/kg etomidate, and, following a 1 µg/kg 60 s bolus dose of fentanil, a 0.1 µg/kg/min fentanil infusion was initiated, after which 0.6 mg/kg rocuronium was administered. In group R (remifentanil group), the following regimen was employed for anaesthesia induction: 1 mg/kg lidocaine, 0.3 mg/kg etomidate and, following a 1 µg/kg 60 s bolus dose of remifentanil, a 0.1 µg/kg/min remifentanil infusion was initiated, after which 0.6 mg/kg rocuronium was administered. Systolic artery pressure, diastolic artery pressure, mean arterial pressure, heart rate, SPO 2 (saturation), cardiac output, stroke volume variance, central venous pressure, and systemic vascular resistance values were recorded for all study patients at five minutes before anaesthetic induction (T1), immediately following induction (T2), and immediately following intubation (T3)., Results: The demographic values obtained for both groups were similar. We found that remifentanil use was associated with decreased cardiac output and increased fluctuations in both heart rate and mean values of arterial pressure., Conclusions: Although many studies have demonstrated remifentanil to be as safe as fentanil when titrated to an appropriate dose, our study suggests that fentanil may be a more appropriate choice during the induction of anaesthesia in patients with a low ejection fraction., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2020 Termedia & Banach.)

Aim: The purpose of this study was to investigate the effect of mexiletine on the neural function and histopathological changes after ischemic spinal cord injury in rabbits. We also compared the effect of mexiletine to that of methylprednisolone., Material and Methods: Twenty six male New Zealand white rabbits were randomly divided into six groups. Group 1; sham operated group (n=3) underwent only the surgical exposure of infrarenal aorta. Group 2 (n=4) received neither intravenous (iv) nor intraperitoneal medication but the infrarenal aorta was cross-clamped. Group 3 (n=5) received intravenous infusion of 20 ml/kg/h normal saline. Group 4 (n=5) received 30 mg/kg intravenous methylprednisolone. Group 5 (n=3) received intraperitoneal 20mg/kg/h normal saline. Group 6 (n=6) received 50mg/kg mexiletine intraperitoneally. Temporary spinal cord ishemia was induced by infrarenal aortic occlusion for 25 minutes and followed by reperfusion. The neural status was scored using the Tarlov criteria at 24 hours after reperfusion. Immediately after the neurological scoring, the spinal cords of all animals were removed for histopathological study., Results: Histopathological examination scores were significantly higher in group 6 compared to group 2 (p < 0.05)., Conclusion: Mexiletine can significantly ameloriate the neural function and prevent histopathological damage after transient spinal cord ischemia in rabbits. This is the first research that investigates the neuron=protective effect of mexiletine in a spinal cord ischemia model.

Background: Comparison of neurological parameters in patients undergoing prosthetic heart valve replacement with two operating techniques-either cardioplegic arrest of the heart under hypothermic cardiopulmonary bypass (CPB) or the heart beating on normothermic bypass, with or without cross-clamping the aorta, without cardioplegic arrest. methods: Fifty valvular surgery patients were randomly assigned into three groups. Sixteen patients underwent beating heart valve replacement with normothermic bypass without cross-clamping the aorta, 17 patients underwent the same procedure with cross-clamping the aorta and retrograde coronary sinus perfusion, and the remaining 17 patients had conventional surgery with hypothermic bypass and cardioplegic arrest., Results: Two-channel electroencephalography (EEG) was recorded to assess changes in cerebral cortical synaptic activity and 95% spectral edge frequency values were recorded continuously. Bispectral monitoring was used to measure the depth of anesthesia. Blood flow rates in middle cerebral artery (MCA) were measured by transcranial Doppler (TCD). Reduction in spectral edge frequency (>50%) or bispectral index (BIS) (<20) or transcranial Doppler flow velocity (>50%) was detected in four patients in Group 1, five patients in Group 2, and three patients in Group 3. BIS or EEG values never reached zero, which indicates isoelectric silence during surgery. Gross neurological examinations were normal in all patients postoperatively., Conclusion: There is no difference regarding neurological monitoring results between on-pump beating heart and hypothermic arrested heart valve replacement surgery. Also no significant difference was encountered among the groups regarding the clinical outcomes.

The aim of this study was to evaluate the effects of propofol, isoflurane, and sevoflurane on middle cerebral arterial blood flow velocity during open heart surgery, and the relationship between these effects and hemodynamic parameters. Fifty-two patients undergoing coronary artery bypass on cardiopulmonary bypass were divided randomly into 3 groups: the first group received 100 microg x kg(-1) x min(-1) propofol, the other groups received one minimum alveolar concentration of sevoflurane or isoflurane for anesthesia maintenance. Middle cerebral arterial blood flow velocities were measured by transcranial Doppler, and hemodynamics were measured by the thermodilution technique. Middle cerebral arterial blood flow velocities decreased significantly after administration of isoflurane and propofol, but there was no significant difference between the groups. After weaning from cardiopulmonary bypass, cerebral blood flow increased and came close to the value after induction in all groups. The pulsatility index and resistivity index increased significantly only after the propofol infusion, but there was no significant difference between the groups.

Background: Antegrade selective cerebral perfusion as a method of cerebral protection during the correction of aortic arch aneurysms and dissections is considered as a safe method for cerebral protection. There are still some questions remaining to be answered; such as whether cerebral perfusion through contralateral hemisphere is adequate., Method: Fifteen consecutive patients (mean age of 53 +/- 3.3 years) underwent surgical reconstruction of aortic arch with antegrade selective cerebral perfusion through the right brachial artery. We monitored maximum, minimum and mean blood flow velocities of bilateral middle cerebral arteries using the transcranial Doppler technique at four different time periods: after induction of anesthesia, during cardiopulmonary bypass, during antegrade selective cerebral perfusion, and after termination of cardiopulmonary bypass. We compared the results of brachial cannulation group with aortic group., Results: Following induction, no significant differences were observed in the right and left middle cerebral artery blood flow velocity measurements in and between the groups. During cardiopulmonary bypass, V(max) and V(mean) decreased significantly in both groups. When two groups were compared there was a significant decrease in the left V(max) values of brachial group (p = 0.048). In-group comparisons revealed that V(max) values were lower in left middle cerebral artery than right middle cerebral artery in brachial group (p = 0.002). With the initiation of antegrade selective cerebral perfusion in brachial group, significant decrease occurred in V(max) and V(mean) when compared with cardiopulmonary bypass values. When left and right sides were compared, although V(min) values remained similar, V(max) and V(mean) values decreased significantly in the left side (p = 0.001 and p = 0.003, respectively). After cardiopulmonary bypass, in both groups, all values restored to initial values and indicated no difference between left and right middle cerebral artery in the groups as well as between the groups. No neurologic deficit was observed in any patient postoperatively., Conclusions: Antegrade selective cerebral perfusion through the right brachial artery, as a method of cerebral protection for aortic arch repair, seems to provide adequate perfusion for both right and left cerebral hemispheres.

Objective: This study is planned to display the efficiency of fast track protocol and its difference from the conventional anesthesia in patients older than 65 years., Methods: One hundred patients older than 65 years underwent coronary artery surgery between October 2000-March 2001 in cardiovascular surgery clinic were considered in this study. Fifty patients in whom fast track protocol was applied were included into the study group, group A; fifty patients underwent conventional anesthesia technique were referred to the control group, group B. In both groups demographic characteristics, early hospital mortality, operation time, total drainage, number of transfusions, stay in the intensive care unit and discharge time were recorded., Results: The mean age was 69.0+/-3.0 years in group A and 70.4+/-3.6 years in group B. Early hospital mortality was 2% in group A, 10% in group B (p>0.05). Intensive care unit stay was 22.01+/-10.12 hours in group A and 60.18+/-32.23 hours in group B (p<0.05). Discharge time was on 5.5+/-1.3 day in group A and on 6.9+/-2.3 day in group B (p<0.05). There were no statistical differences between the two groups in respect to other parameters., Conclusion: Fast track protocol in patients older than 65 years is a suitable technique by using modern cardiac surgery methods. This protocol is successfully used by selecting the suitable patients and following the patients carefully in the postoperative period.