Ertan Öztürk

RELIEF OF CHRONIC REFRACTORY HICCUPS WITH GLOSSOPHARYNGEAL NERVE BLOCK

hours. The microscope was moved in close to the operating table, and thereafter the damping was observed. A search for common causes included lack of pressure in the pressure bag, position of the arterial line at the wrist, and any evidence of blood clots in the line, all of which were negative. The microscope was not interfering with the arterial line. Both the flushing and the withdrawal of blood from the line was successful. The noninvasive blood pressure on the opposite hand showed the patient to be normotensive. We were considering inserting a new radial line when we discovered that a surgical clamp was occluding the pressure line. The clamp had been put in by the nurse to secure all the wires from the microscope along the bed and had inadvertently clamped our radial artery line. When damping occurs, it is important to inspect the pressure line between the transducer and the radial artery.

Maximum power point tracking quadratic boost converter for photovoltaic systems

Providing maximum utilization of the photovoltaic system is one of the significant challenges. Therefore, converter technologies and maximum power point tracking algorithms are important research topics. In this study, a quadratic boost converter with high conversion ratio is proposed. The proposed quadratic converter not only steps up the PV voltage which is commonly low, it also tracks the maximum power point of the PV system under varying operation conditions. The incremental conductance method is used as maximum power point tracking algorithm. Thus, productivity of the PV system is increased. It is seen from simulation results that, proposed system has fast tracking capability even under fast irradiation changes and less oscillation besides the features of high voltage conversion gain.

Comparison of Parasacral and Posterior Sciatic Nerve Blocks Combined with Lumbar Plexus Block.

OBJECTIVE The aim of this study is to compare the effects of parasacral and posterior Winnie approaches when combined with the inguinal paravascular approach for lumbar plexus block. METHODS After the approval of the Ethics Committee, 40 patients scheduled to undergo arthroscopic knee surgery were enrolled. The patients were randomly assigned into two groups in a double-blind manner to perform sciatic nerve block either by the parasacral technique (Group I) or by the posterior approach (Group II). RESULTS The obturator nerve motor block success rate was found to be 80% (16/20) in Group I, whereas it was 10% (2/20) in Group II (p<0.05). CONCLUSION Inguinal paravascular block with parasacral sciatic nerve block led to a much higher incidence of obturator nerve motor block when compared to the inguinal paravascular block with posterior sciatic nerve block during knee arthroscopies.

Perineural meperidine blocks nerve conduction in a dose-related manner: a randomized double-blind study.

Background: Meperidine has been shown to exhibit a sensory block in peripheral nerves. However, its motor blockade ability is controversial. The aim of this study was to investigate, electroneurographically, the ability of meperidine to inhibit conduction in both sensory and motor fibres in the ulnar nerve.

Continuous spinal anesthesia after unintentional dural puncture during attempted epidural anesthesia for mastectomy

(1:200,000) was used subcutaneously in the axilla of all patients to abolish tourniquet sensation transmitted by the intercostobrachial and medial brachial cutaneous nerves. Axillary blocks were placed using either a transarterial technique, a paresthesia technique, or by a perivascular technique. A nerve stimulator was not used. Each patient recorded the number of pain pills used on the day of surgery and for the following 2 days. The duration of sensory analgesia (the time in which they felt no pain) lasted an average of 23 hours in blocks using methylprednisolone as compared with 16 hours without the steroid (P .01). Motor block (when they could not move their hand or fingers) averaged 19 hours with the steroid and 13 hours without the steroid (P .001). Using 95% confidence interval analysis, we found that the motor blocks were prolonged between 3.4 and 9.4 hours. The sensory blocks, which were associated with larger standard deviations, were extended between 1.7 and 12.1 hours. The 2 groups did not differ in the number of analgesics they required or in the level of pain they experienced after the day of surgery. However, on the day of surgery itself, patients who had received the steroid had significantly lower pain scores. The difference in the number of pain pills taken did not reach statistical significance. There were no anesthetic complications noted by the anesthesia staff or surgeons in the postoperative period. Adding a steroid to the local anesthetic solution may not be indicated for all patients. Diabetic patients may experience hyperglycemia. Patients with an ongoing infectious process may be detrimentally affected by the anti-inflammatory effects of steroids. Our preliminary data suggest that methylprednisolone can increase the duration of sensory and motor block. Although we relied on the patients to determine the duration of their block, the results from the questionnaires were consistent. The applicability of these findings to clinical practice must be verified in a randomized prospective clinical trial.

An unmasked neurological pathology (schwannoma) following spinal anesthesia.

A neurological deficit occurred following spinal anaesthesia that unmasked a relatively important neurological pathology. Spinal anesthesia was performed between L3 and L4 by midline approach at the first attempt. Postoperative clinical examination of the patient showed sensory loss below the T5 segment. Whenever new neurological signs are seen after regional anesthesia, further investigations should be done immediately for differential diagnosis.

P22.2 Effect of perineurally administered tramadol on nerve conduction

Background: It has been shown that the admixture of tramadol with mepivacaine for axillary plexus block provides a prolongation of blockade. Moreover, it was postulated that tramadol has local anesthetic-like effect in an invitro study. Objective: By using an electroneurographical method, we investigated if tramadol had a nerve conduction blocking effect when administered perineurally in vivo. Methods: After approval by the Ethics Committee of our institution and obtaining informed consent from healthy volunteers, 24 cases were randomized into four equal groups [saline (placebo), 0.5% tramadol, 1% tramadol and 1.5% tramadol]. The study was designed to be double-blinded. Two milliliters of working solution was administered to sural nerve perineurally at the level of ankle using a nerve stimulator. Sensory response amplitudes were recorded electroneurographically. A minimum of 20% decrement with respect to control amplitude was sought to accept that the block had occurred. Results: According to electroneurographical recordings, none of the volunteers in saline group had block. However, the block rates with 0.5%, 1% and 1.5% tramadol were 1/6, 4/6 and 6/6, respectively (p < 0.05). The maximum decrement in the sensory response amplitudes with respect to control amplitudes given as median values were as follows: 7.8% with saline; 12.5% with 0.5% tramadol; 38.5% with 1% tramadol; 77.5% with 1.5% tramadol (p < 0.05). While the median duration of sensory block with 1% tramadol was 15 min, it was 35 min with 1.5% tramadol. Conclusion: Perineural tramadol blocks sensory conduction in peripheral nerves.