Bengü Gülhan Aydın

Anesthesia methods used by anesthetic specialists for circumcision cases. National survey study for Turkey

Objectives: To examine the anesthesiologist’s choice for anesthesia techniques and drugs in circumcision and determine the preoperative examination, intraoperative monitoring techniques, postoperative analgesia methods, and common complications among anesthesiologists working in Turkey. Methods: This cross-sectional study was conducted at Bulent Ecevit University Hospital, Zonguldak, Turkey, between May and July 2012. Survey data were obtained via survey forms through electronic data over the web. The questionnaire consists of 20 questions. These questions included demographic data, methods of anesthesia for circumcision, postoperative analgesia methods, and monitoring methods. Results: The data were obtained from 206 anesthesiologists who agreed to participate in the survey. Circumcision was performed most frequently in the age group of 3-6 years old. It was found that 47% of routine preoperative laboratory tests were coagulation parameters and complete blood count tests. The most common method of anesthesia was laryngeal mask. The frequency of administration of regional anesthesia was 37.4%, and caudal block was more preferable. Bupivacaine as a local anesthetic in regional anesthesia and midazolam and ketamine were the most preferred agents in sedoanalgesia. During regional anesthesia, ultrasound was most often used by anesthesiologists (31.6%). Conclusion: Ambulatory anesthesia protocols, which are also needed in circumcision, can be improved with international recommendation, and these protocols could be conformed as sociocultural structure in societies. This study should be regarded as a preliminary study to attract attention on anesthesia techniques in circumcision.

Neuroprotective effects of Quercetin on radiation-induced brain injury in rats

Abstract Extensive research has been focused on radiation-induced brain injury. Animal and human studies have shown that flavonoids have remarkable toxicological profiles. This study aims to investigate the neuroprotective effects of quercetin in an experimental radiation-induced brain injury. A total of 32 adult male Wistar-Albino rats were randomly divided into four groups (control, quercetin, radiation, and radiation+quercetin groups, with eight rats in each group). Doses (50 mg/kg) of quercetin were administered to the animals in the quercetin and radiation+quercetin groups; radiation and radiation+quercetin groups were exposed to a dose of 20 Gy to the cranium region. Tissue samples, and biochemical levels of tissue injury markers in the four groups were compared. In all measured parameters of oxidative stress, administration of quercetin significantly demonstrated favorable effects. Both plasma and tissue levels of malondialdehyde and total antioxidant status significantly changed in favor of antioxidant activity. Histopathological evaluation of the tissues also demonstrated a significant decrease in cellular degeneration and infiltration parameters after quercetin administration. Quercetin demonstrated significant neuroprotection after radiation-induced brain injury. Further studies of neurological outcomes under different experimental settings are required in order to achieve conclusive results.

Entübasyon sırasında oluşan dental travmaya yaklaşım: olgu sunumu

Genel anestezi sirasinda bildirilen dis travmasi insidansi % 0.06-12.3’dir. Perioperatif dental travmalarin cogu laringoskopi ile entubasyon sirasinda ortaya cikarken, airway, endotrakeal tup ya da larengeal maske cikarilmasi icin asiri kuvvet uygulandiginda da gorulmektedir. Dental yaralanmalar basit kiriktan restorasyon kaybi veya avulsiyona (disin soketinden cikmasi) kadar degisebilir. Dental yaralanma genellikle ust on bolgede meydana gelir ve laringoskopun konumu nedeniyle sol orta kesici dis en sik etkilenir. Genel anestezi uygulamalarinda karsilasilabilecek dental travmalara yaklasimimizi olgu uzerinden aktarmayi amacladik.

The effect of gender on reversal of non-depolarizing block with Sugammadex -

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.

The effect of sugammadex on postoperative cognitive function and recovery

BACKGROUND AND OBJECTIVE Sugammadex is the first selective relaxant binding agent. When compared with neostigmine, following sugammadex administration patients wake earlier and have shorter recovery times. In this study, we hypothesized that fast and clear awakening in patients undergoing general anesthesia has positive effects on cognitive functions in the early period after operation. METHODS Approved by the local ethical committee, 128 patients were enrolled in this randomized, prospective, controlled, double-blind study. Patients were allocated to either Sugammadex group (Group S) or the Neostigmine group (Group N). The primary outcome of the study was early postoperative cognitive recovery as measured by the Montreal Cognitive Assessment (MoCA) and Mini Mental State Examination (MMSE). After baseline assessment 12-24h before the operation. After the operation, when the Modified Aldrete Recovery Score was ≥9 the MMSE and 1h later the MoCA tests were repeated. RESULTS Although there was a reduction in MoCA and MMSE scores in both Group S and Group N between preoperative and postoperative scores, there was no statistically significant difference in the slopes (p>0.05). The time to reach TOF 0.9 was 2.19min in Group S and 6.47min in Group N (p<0.0001). Recovery time was 8.26min in Group S and 16.93min in Group N (p<0.0001). CONCLUSION We showed that the surgical procedure and/or accompanying anesthetic procedure may cause a temporary or permanent regression in cognitive function in the early postoperative period. However, better cognitive performance could not be proved in the Sugammadex compared to the Neostigmine.

O efeito de sugamadex sobre a função cognitiva e recuperação no pós-operatório

BACKGROUND AND OBJECTIVE Sugammadex is the first selective relaxant binding agent. When compared with neostigmine, following sugammadex administration patients wake earlier and have shorter recovery times. In this study, we hypothesized that fast and clear awakening in patients undergoing general anesthesia has positive effects on cognitive functions in the early period after operation. METHODS Approved by the local ethical committee, 128 patients were enrolled in this randomized, prospective, controlled, double-blind study. Patients were allocated to either Sugammadex group (Group S) or the Neostigmine group (Group N). The primary outcome of the study was early postoperative cognitive recovery as measured by the Montreal Cognitive Assessment (MoCA) and Mini Mental State Examination (MMSE). After baseline assessment 12-24h before the operation. After the operation, when the Modified Aldrete Recovery Score was ≥9 the MMSE and 1h later the MoCA tests were repeated. RESULTS Although there was a reduction in MoCA and MMSE scores in both Group S and Group N between preoperative and postoperative scores, there was no statistically significant difference in the slopes (p>0.05). The time to reach TOF 0.9 was 2.19min in Group S and 6.47min in Group N (p<0.0001). Recovery time was 8.26min in Group S and 16.93min in Group N (p<0.0001). CONCLUSION We showed that the surgical procedure and/or accompanying anesthetic procedure may cause a temporary or permanent regression in cognitive function in the early postoperative period. However, better cognitive performance could not be proved in the Sugammadex compared to the Neostigmine.