Füsun Eroğlu

The effect of lidocaine/prilocaine cream on an experimental wound healing model.

The effects of lidocaine/prilocaine cream on wound healing were evaluated in this study. An incisional wound model on abdominal wall was performed on mice. A full thickness skin incision 2 cm in length was performed then it was sutured primarily with 4/0 polypropylene. In group I (n  = 10) only suturing was done (control group), in group II (n  = 10) lidocaine cream was applied after suturing on wound site and it was repeated for 6 days (twice in a day), in group III (n  = 10) lidocaine/prilocaine cream was applied topically after suturing and repeated 6 days (twice in a day). At day 7, incisions were excised for evaluating tensile strength and 5-hydroxyproline (5-HP) values. Tensile strength values were lowest in control group and highest in lidocaine/prilocaine treatment group. 5-HP values were also expressed the same results. Both tensile strength and 5-HP values increased significantly in treatment groups in regard to the control (p  < 0.05). It was concluded that lidocaine/prilocaine cream as topical anaesthetic agent had no adverse effect in an incisional wound model, furthermore it may have some beneficial effects on wound healing which remains to be evaluated and it can be used safely in day-to-day emergency practices.

New volatile anesthetic, desflurane, reduces vitamin E level in blood of operative patients via oxidative stress.

It has been well known that some volatile anesthetic agents produce oxidative stress. Desflurane as a new volatile agent might have limited oxidative toxic effect because it is relatively a new short‐acting anesthetic characterized by a short duration of action and a quick postanesthetic recovery. We investigated effect of desflurane on serum glutathione peroxidase (GSH‐Px), lipid peroxidation (LP), vitamin E, and erythrocyte superoxide dismutase (SOD) values in patients. Fifteen adult patients are scheduled for elective surgery, ASA I or II physical status. Tidal volume and ventilation frequency were kept unchanged during the operation. Baseline values in venous blood samples were preoperatively taken and blood was also taken postoperatively at the 1st and the 12th hours of desflurane exposure. LP levels were significantly (p < 0.05) higher postoperatively at 1st hour than in preoperative values while α‐tocopherol concentration was significantly (p < 0.001) lower in postoperative period at 1st hour than in preoperative period. Erythrocyte SOD and serum GSH‐Px activities did not differ between pre‐ and postoperative periods. In conclusion, we observed that desflurane produced oxidative stress by decreasing α‐tocopherol levels. Use of vitamin E may be possible to reduce the oxidative effect of desflurane. Copyright

Prophylactic effects of systemic oral ephedrine in spinal anesthesia-induced hypotension during transurethral prostatectomy

Objective: We investigated the prophylactic effects of systemic oral ephedrine in spinal anesthesia-induced hypotension during transurethral prostatectomy. Material and Methods: Sixty American Society of Anesthesiologists Grade II and III patients scheduled for spinal anesthesia were randomized into one of two groups. Patients in Group I ( n r = r 30) received oral ephedrine 50 r mg in addition to premedication whilst those in Group II ( n r = r 30) received only premedication 30 r min before spinal anesthesia. Pre-infusion values were measured in order to obtain baseline readings after oral ephedrine administration in Group I and after premedication in Group II. Systolic arterial pressure (SAP) and heart rate (HR) were recorded before and after infusion, during and 5 r min after spinal anesthesia and intraoperatively. Hypotension was defined as SAP <100 r mmHg and <20% of baseline value. Hypotension was treated with 3 r mg ephedrine and bradycardia was corrected with atropine 0.5 r mg, given as an i.v. bolus. Results: SAP values were significantly lower in Group II during the spinal anesthesia, post-spinal and intraoperative periods ( p r < r 0.0001). Fifteen patients received ephedrine in Group II and seven in Group I. Supplemental ephedrine was used at doses of 3.42 r - r 0.97 r mg in Group I and 8.86 r - r 1.24 r mg in Group II. The incidence of hypotension was halved in Group I compared to Group II (23.33% vs 50%, p r = r 0.003). Six patients received atropine in Group II because of severe bradycardia. Mean HR values were lower in Group II than Group I during the spinal anesthesia, post-spinal and intraoperative periods. Conclusions: We conclude that a prophylactic oral dose of ephedrine 50 r mg is effective for minimizing and managing spinal anesthesia-induced hypotension during transurethral prostatectomy.

The effect of colloidal fluid replacement on wound healing in an experimental sublethal hemorrhagic shock model.

Objective The aim of the study was to evaluate the effects of different resuscitation solutions on wound healing in an animal model of sublethal hemorrhagic shock. Methods Sublethal hemorrhagic shock was established by blood withdrawal until the mean arterial pressure fell to 40 mmHg within 15 min. Animals were resuscitated with four different solutions: group I (n=19) 0.9% NaCl, group II (n=20) 10% dextran 40, group III (n=20) 6% hydroxyethyl starch, group IV (n=18) 4% modified fluid gelatin. Following inhalation anesthesia, a full thickness skin incision of 2 cm in length was made on the abdominal wall and sutured primarily. The incision wound on the abdominal wall was excised on the fifth day. The breaking strength of the incision and hydroxyproline content of dry tissue were evaluated. Results Differences in breaking strength values were observed between groups I–III and I–IV (P<0.05). Hydroxyproline values were significantly lower in group IV (58.47 μg/ml) and group II (69.17 μg/ml) (P<0.05). The gelatin-resuscitated group had lower breaking strength and hydroxyproline values than the other groups. Conclusion It can be concluded that resuscitation with modified fluid gelatin may have detrimental effects on wound healing in an experimental model of sublethal hemorrhagic shock.

Rhabdomyolysis and Renal Insufficiency Due to Synthetic Cannabinoid Intoxication

Bonsai, which is the street name of synthetic marijuana is a psychoactive substance. Since synthetic cannabinoids (SC) are easily accessible and cheap, their use is becoming widespread day by day. Cannabinoids are lipid soluble and non-polar, and consist of 22 to 26 carbon structure/atoms (1). Also they easily evaporate when smoked. These SC effects are carried out through CB1 and CB2 receptors and the active ingredient is delta-9-tetrahydrocannabinol (THC). While CB1 receptors are responsive from the psychoactive component of cannabinoids, the CB2 receptors control the release of cytokines and the migration of immune cells (2,3). The use of SC causes mental status changes, seizures, central nervous system depression, hallucinations, anxiety, and vivid dreams (4). In the literature, there have been cases that developed rhabdomyolysis depending on the use of SC. However, the number of cases that was monitored and treated with consecutive plasma exchange therapy (PET) and hemodialysis treatment are quite a few (5-7). ABSTRACT Bonsai is the street name of synthetic marijuana, which is a psychoactive substance. Since synthetic cannabinoids are easily accessible and cheap, their use is becoming widespread day by day. It can cause not only various clinical symptoms but also severe rhabdomyolysis. In this case, with severe rhabdomyolysis, we tried to discuss the treatment challenges of the patient examined in intensive care unit with the history of bonsai use.

T142 DOES WOUND INFILTRATION OF TRAMADOL REDUCE POSTOPERATIVE PAIN IN LAPAROSCOPIC OR OPEN HERNIOGRAPHY

Introduction: The laparoscopic approach may be associated with more postoperative pain initially. The aim of this study was to evaluate the effects of administered tramadol at wound closure on postoperative pain and analgesic requirements under spinal anesthesia in laparoscopic inguinal herniorrhaphy (LH) or tension free open inguinal herniorrhaphy (TFOH). Methods: Twenty patients were randomly divided into two groups (n= 10 in each) as LH or TFOH. Patients received infi ltration of 200 mg tramadol with 40 mL of 0.9% saline solution at wound closure procedure. Postoperative pain was assessed with a Visual Analog Scale (VAS) at 3, 6, 12, and 24 hours postoperatively. Additional requirements of tramadol for postoperative pain releif were registered. Results: VAS scores at postoperative 12 and 24 hours were signifi cantly higher according to 3rd hour VAS scores in both groups. The VAS scores at 12 hours after operation signifi cantly lower in LH group than in TFOH group (1.5 ± 0.97 vs 5.1 ± 0.99). Additional requirements of tramadol for postoperative pain releif were signifi cantly lower in LH group. Conclusion: We conclude that wound infi ltration of 200 mg tramadol reduce postoperative pain in LH group.

The analgesic effect of EMLA cream on sore throat following tracheal intubation

AbstractSore throat and hoarseness are the most common anaesthesia side effects. The aim of this study was to evaluate the analgesic effect of EMLA cream on sore throat after intubation. Adult patients (105) with ASA I-II scores who had elective surgery were followed for throat complaints. There were 58 patients in the control group, and 47 patients in the EMLA group whose endotracheal tube cuffs were treated with 0.5 ml EMLA cream before intubation. Throat complaints (sore throat, hoarseness, burning sensation) were evaluated after the operations. Respectively, 55.1% and 31.9% of patients complained of sore throat in the control and EMLA groups. The difference between groups was statistically significant (p < 0.05). Hoarseness was significantly more frequent in the control group than in the EMLA group, and the burning sensation was more frequent in the EMLA group (p < 0.05). No correlation was observed between the duration of operations, the types of operations and the use of muscle relaxants with sore t...

Laparaskopik Kolesistektomide Granisetron ve Granisetron-Droperidol Kombinasyonunun Postoperatif Bulantı Kusma Üzerine Etkileri

SuleymanDemirel Universitesi TIP FAKULTESI DERGISI: 2000 Mart; 7(1) Laparaskopik Kolesistektomide Granisetron ve Granisetron-Droperidol Kombinasyonunun Postoperatif Bulanti Kusma Uzerine Etkileri Sadik Ozmen, Fusun Eroglu, Lutfi Yavuz, Cemalettin Aydin Ozet Elektif laparoskopik kolesistektomi planlanan 60 olguda postoperatif bulanti kusma (POBK) profilaksisinde granisetron ve granisetron-droperidol kombinasyonunun etkinligini arastirmayi amacladik. Tum olgularda anestezi induhsiyonu 5 mg/kg tiyopenton, 2 mikrogram/kg fentanil, 0.5 mg/kg atrakuryum ile, idame % 2-2.5 konsantrasyonda sevofluran ile saglandi. Olgular rasgele iki gruba ayrildi. Grup G (n: 30) olgulara induksiyondan hemen once 3 mg granisetron; Grup GD (n: 30) olgulara 3 mg granisetron ve 1.25 mg droperidol IV verildi. Granisetron-droperidol kombinasyonu kullanilan olgularda POBK profilaksisi tama yakin etkinlik saglarken, yalniz granisetron kullanilan olgularda POBK sikligi daha fazla olarak saptandi. Anahtar Kelimeler: Granisetron, droperidol, postoperatif bulanti kusma. Abstract Effect of Granisetron and Granisetron Plus Droperidol on Postoperative Nausea And Vomiiting in Laparoscopic Cholecystectomy The aim of this study was to evaluate the effects of two different anesthetic techniques on postoperative recovery and the effectiveness of prophylactic granisetron and granisetron plus droperidol for the preventing of postoperative nausea and vomiting (PONY) in 60 patients who were undergone elective laparoscopic cholecystectomy. Induction of anesthesia was induced with propofol + fentanyl + atracurium IV, maintained with propofol infusion in group P (n:30) and induced with thiopentone + fentanyl + atracurium IV, maintained with sevoflurane in group S (n:30). Group P and group S were divided into two subgroups for prophylaxis of PONV. Group P-G and group S-G received 3 mg granisetron, group P-GD and group S-GD received 3mg granisetron + 1.25 mg droperidol IV just before induction. Prophylaxis of PONV provided almost complete effectiveness in the patients who received granisetron + droperidol. Key Words: propofol, sevoflurane, granisetron, droperidol, postoperative nausea and vomiting.