Aim: The aim was to investigate the effects of preoperative anxietyand general anesthetic administrations on intraoperative awarenessamong patients undergoing cesarean section.Methods: This prospective randomized study included 90 pregnantsubjects. Preoperative anxiety was assessed using the Beck AnxietyInventory. The patients were divided into three groups: group Preceived propofol 2.5 mg/kg, group T thiopental 5 mg/kg and groupK received ketamine 1 mg/kg. Data on intraoperative hemodynamics,isolated forearm (IFA) responses and time to first pain and to firstanalgesic requirement evaluated using postoperative numerical ratingscale were recorded. The Modified Brice Scale (MBS) was used toassess awareness.Results: The preoperative anxiety levels in the groups were low anddemographic data were similar (p>0.05). There was no statisticallysignificant difference in IFA response between the groups (p>0.05).Group T had higher MAP at all times and NRS values at hour 0compared to the other groups (p<0.05), and had shorter time to firstanalgesic requirement (p<0.05). MBS responses were evaluated asrecall in 12 cases in group K, four in group P and three in group T.Conclusion: As the anxiety levels in pregnants were low, the superiorityof agents used in induction over each other regarding awareness couldnot be shown.
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Introduction: Standard drug syringe labels can reduce drugerrors. In this study, it was aimed to report the attitudes ofanesthesia workers (AW) towards labeling, to emphasize theimportance of drug labeling in drug errors and to contributeto safe anesthesia practices by raising awareness aboutstandardization.Methods: The study was initiated after obtaining permissionfrom the Zonguldak Bülent Ecevit University Clinical ResearchEthics Committee. A confidential, self-reporting questionnairewas sent to each member of Turkish Anesthesiology andReanimation Society and to technicians whose e-mail addresseswere known.Results: A total of 189 people participated. Of all participants,49.2% were aware of standard syringe label (SSL). While 67.3%of these participants stated that they used color-coded selfadhesivelabels, 47% stated that they did not know whichstandards these labels met. AWs suggested that color-coded selfadhesivelabels (92.9%), SSL for vials (97.3%) and pre-preparedsyringes (87.8%) were effective in reducing drug administrationerrors (DAE). Of all participants, 89.9% stated that they did notknow DAE and 84.7% stated that they read the label each timebefore administration. AWs stated that DAE could be preventedthrough standard labeling procedures (47%), attention (23%),education (21%) and producing the vials in different sizes andcolors (9%).Conclusion: AWs stated that developing and standardizingthe vial labels, scheduling trainings, paying care and attentionwere important in prevention of labeling-related errors.
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Aim: The aim of our study was to evaluate specific factors in predictingdifficult mask ventilation (DMV) in obese patients undergoing electivesurgery.Methods: This prospective and observational study was performedin 90 obese patients. We assessed age, height, weight, sex, bodymass index (BMI), dental structure, presence of facial hair, modifiedMallampati test result, mouth opening, thyromental distance (TMD),sternomental distance, mandibular protrusion, mandibular length,neck circumference (NC), neck length, upper lip bite test result, heightto TMD ratio, NC to TMD ratio (NC/TMD), and history of snoring andObstructive Sleep Apnea syndrome for estimation of DMV.Results: The mean age of the patients was 40.9±9.4 years andthe mean BMI was 44.7±6.2 kg/m2. Of all patients 38.9% weredetermined to have DMV. Clinical variables associated with DMV weremale gender, mandibular length, snoring, NC, and NC/TMD. Multiplelogistic regression analysis showed that male gender (p=0.047) andsnoring (p=0.02) were independent factors.Conclusion: We believe that NC/TMD and ML are predictive testsfor DMV in obese patients. Tests and measurements at the bedsideare not sufficient alone and we believe that they will be more reliablewhen considered together.
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The incidence of dental trauma reported during general anesthesia is 0.06-12.3%. The majority of perioperative dental trauma occurs during laryngoscopy and intubation, it may be observed when excessive force is applied to remove the airway, endotracheal tube or laryngeal mask. Dental injury may vary from simple fracture to restoration loss or avulsion (removal of tooth from the socket). Dental injury generally occurs in the upper front region and the left central incisor is most frequently affected due to the position of the laryngoscope. We aim to share an approach to dental trauma that may be encountered during general anesthesia administration in this case report.
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Amaç: Elektrokonvülzif tedavi (EKT), etkin ve yaşam kurtarıcı bir tedavi yöntemi olmakla beraber, etkisi ve yan etkileri hala tartışılmaktadır. Çalışmamızda EKT’nin apne döneminde oksijen (O2) uygulamasının Near Infrared Spektroskopi ile serebral oksijenizayon üzerine ve EKT sonrası komplikasyonlar üzerine etkisini değerlendirmeyi amaçladık. Yöntem: Bu ileriye dönük, gözlemsel çalışmaya ilk kez EKT planlanan 40 hasta katılmıştır. Tüm hasta-lara serebral oksimetre ve bispektral indeks sensörleri (BİS) uygulandı. Hastalar nazal kanül ile 6 L/dk O2 uygula-ması yapılan hastalar Grup O (s=20), O2 uygulanmayan hastalar Grup K (s=20) olarak rastgele ikiye ayrıldı. Nöbet sırasında ve nöbetten 10 dakika sonra hemodinamik veriler, end-tidal karbondioksit (EtCO2), bölgesel serebral doku oksijen satürasyonu (rSO2 ) ve BİS değerleri ile EKT sonrası komplikasyonlar kaydedildi. Sonuçlar: Nöbet sırasında ölçülen rSO2’deki değişim ve demografik özellikler açısından gruplar arasında anlamlı bir fark saptanmadı (p>0.05). EKT sırasında desatürasyon (SpO2<%90) hastalarımızın %12.5'inde gözlendi. Bu beş hastanın dördü Grup K'de, biri Grup O'da idi. Nöbet sonrası EtCO2 değerleri Grup C'de anlamlı olarak yüksek bulundu. EKT sonrası görülen komplikasyon oranı Grup K’de daha yüksek bulundu. Tartışma: EKT gibi serebral oksijen tüketiminin arttığı pro-sedürlerde anestezi süresinin kısa olması nedeniyle serebral oksijen monitorizasyonunun klinik olarak yararı görüle-memiştir. Bunun yanında apne döneminde O2 uygulanmasının EKT sırasında ve sonrasında oluşabilecek solunum komplikasyonlarını azaltabileceği kanısına varılmıştır. (Anadolu Psikiyatri Derg 2018; 19(5):472-477)
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Moyamoya disease is a chronic cerebrovascular disease characterized by the development of compensatory collateral vessels due to progressive narrowing or obstruction of the intracranial arteries. Neurological complications after coronary bypass in patients with Moyamoya disease may be prevented by recent technical developments, surgical modifications, and cerebral monitorization. The objective of perioperative anesthetic management is to provide balance between oxygen supply and consumption of the brain. In this case report, we aim to share our anesthetic experience in a patient with Moyamoya disease who underwent off-pump coronary artery bypass surgery and cerebral oximetry monitoring.
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Genel anestezi sırasında bildirilen diş travması insidansı % 0.06-12.3'dir. Perioperatif dental travmaların çoğu laringoskopi ile entübasyon sırasında ortaya çıkarken, airway, endotrakeal tüp ya da larengeal maske çıkarılması için aşırı kuvvet uygulandığında da görülmektedir. Dental yaralanmalar basit kırıktan restorasyon kaybı veya avulsiyona (dişin soketinden çıkması) kadar değişebilir. Dental yaralanma genellikle üst ön bölgede meydana gelir ve laringoskopun konumu nedeniyle sol orta kesici diş en sık karşılaşılabilecek dental travmalara yaklaşımımızı olgu üzerinden aktarmayı amaçladık.
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Aim: The aim of this study was to evaluate the protective use ofquercetin in a rat model of radiation-induced enteritis and colitis.Methods: Twenty four adult rats were randomly divided into fourgroups. Group SHAM was given only physiological saline, group QUERwas given quercetin 50 mg/kg for 15 days, group RAD was given onlyirradiation and group QUER+RAD was given quercetin 50 mg/kg, andthen irradiated. Twenty four hours after the exposure to radiation,all rats were euthanized for the evaluation of the ileum and colonmorphology and biochemical measurements.Results: Compared with the SHAM group, the serum malondialdehyde(MDA) level was significantly higher in group RAD (p=0.004) andwas significantly decreased in group QUER+RAD (p=0.015). TheMDA levels in the ileum and colon tissues were significantly higherin group RAD (p=0.004 and p=0.002, respectively), while treatmentwith quercetin significantly reduced lipid peroxidation in both tissuesin group QUER+RAD (p=0.015 and p=0.009, respectively). Comparedwith the control group, the serum total antioxidant status (TAS) levelwas significantly lower in Group RAD (p=0.002) and was significantlyincreased in group QUER+RAD (p=0.009). TAS in the ileum and colontissues were significantly lower in group RAD (p=0.002 and p=0.002)and were significantly higher in both tissues in group QUER+RAD(p=0.002 and p=0.002, respectively).Conclusion: This study confirmed that, in the model of radiationinducedileitis and colitis in rats, quercetin effectively decreased oxidativestress and inflammatory damage to both ileum and colon tissues.
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Sugammadex is a rapid and selective aminosteroid agent that has entered use recently. We aimed to research the effect of gender on reversal of non-depolarizing block with sugammadex. We designed a prospective study. The research included a total of 100 cases who underwent rhinoplasty operation administered general anaesthesia. Cases were divided according to gender as male (Group M) and female (Group F). At the end of the operation for patients with TOF value 25%, patients were given 2 mg kg-1 iv sugammadex. Duration from the rocuronium administration until the TOF value was zero(TOF0), the time from sugammadex administration until TOF reached from 25% to 90% was recorded (TOF25-90). The time from TOF90 to extubation was named the extubation duration. From the time the patients entered the PCU until Aldrete score was ≥9 was named the recovery duration and recorded. The time for the groups to TOF25-90 was 123.84 ± 38.03 s in Group M and 122.06 ± 30.461 s in Group F (p > 0.05). The extubation duration was 189.68 ± 41.37 s in Group M and 206.50 ± 45.99 in Group F (p = 0.316). The recovery time was 8.26 ± 14 min in Group M and 8.48 ± 14.23 min in Group F (p = 0.328). After the administration of sugammadex, there was no difference observed between the groups in terms of the TOF25-90 duration, recovery and extubation duration. As a result, conclusion was reached that gender did not affect rocuronium reversal with sugammadex
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Apert syndrome is an autosomal dominant inherited mandibulofacialdysostosis characterized by craniosynostosis, syndactyly, high forehead,broad nose, maxillary hypoplasia, synostosis of cervical vertebrae,organ malformations, and mental retardation. It is rarely encounteredand as there is little knowledge of the anesthesia practice for thissyndrome in the literature, we present our anesthesia experience of acase undergoing bilateral syndactyly surgery.
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