İbrahim Kurt

Comparison of local, spinal, and general anaesthesia for inguinal herniorrhaphy.

OBJECTIVE To compare local, spinal, and general anaesthesia for inguinal hemiorraphy in otherwise healthy patients with respect to duration of operation, time in operating room, postoperative pain, complications, rehabilitation, and satisfaction. DESIGN Prospective randomised controlled trial. SETTING University hospital, Turkey. SUBJECTS Seventy-five men with unilateral primary inguinal hernias, Nyhus type II and III, and ASA I and II. INTERVENTIONS Lichtenstein repairs with standard local, spinal, or general anaesthesia. MAIN OUTCOME MEASURES Duration of operation and anaesthesia, postoperative pain scores, analgesic requirements, complications, length of hospital stay, postoperative rehabilitation, and satisfaction. RESULTS With local anaesthesia, we recorded shorter time spent in the operating room, lower incidence of nausea and urinary retention, and more satisfaction. In the local and spinal anaesthetic groups, postoperative analgesic requirements and length of hospital stay were less than in the general anaesthesia group. CONCLUSIONS Local anaesthesia is suitable for day-case hernia repair with fewer postoperative problems and less analgesia requirement. Patients also reported greater satisfaction. Local anaesthesia may be preferred to other methods.

Atrophic and Regenerative Changes in Rabbit Mimic Muscles after Lidocaine and Bupivacaine Application

Destruction and denervation atrophy in skeletal muscles caused by the injection of local anaesthetics was investigated by injecting lidocaine or bupivacaine around the rabbit facial nerve to produce facial paralysis. Animals were then sacrificed at 2, 4, 6, and 8 weeks post‐injection, and changes in mimic muscle tissue were assessed at each stage by light microscopy and electron microscopy. Atrophic changes were observed at 2–6 weeks after injection, and regeneration started at 6–8 weeks. Compared to bupivacaine, lidocaine caused more dramatic atrophic changes and was associated with slower muscle regeneration.

EFFECTS OF ADDING ALFENTANIL OR ATRACURIUM TO LIDOCAINE SOLUTION FOR INTRAVENOUS REGIONAL ANAESTHESIA

BACKGROUND AND OBJECTIVE The addition of alfentanil or atracurium to lidocaine solution for intravenous regional anaesthesia of the arm may have advantages with respect to improved muscle relaxation and better analgesia. The study investigates these possibilities. METHODS We investigated 33 patients. Plain lidocaine solution was administered to Group 1 (n = 11). Alfentanil (0.5 mg) and atracurium (3 mg) were added to the lidocaine solution in Groups 2 (n = 11) and 3 (n = 11), respectively. The onset of sensory and motor block, intra- and postoperative pain scores, and the duration of postoperative analgesia were evaluated. RESULTS There was a significant difference in the speed of the onset of sensory block in the hand, but not at the tourniquet site. The onset of the motor block, intra- and postoperative pain scores, and the duration of postoperative analgesia were similar in all groups. CONCLUSIONS No clinical benefits of adding alfentanil or atracurium to lidocaine solution for intravenous regional anaesthesia of the arm could be shown.

A simple and inexpensive nasal cannula to prevent rebreathing for spontaneously breathing patients under surgical drapes.

IMPLICATIONS A new nasal cannula that provides oxygenation and suctioning simultaneously prevents rebreathing during surgery in spontaneously breathing patients under surgical drapes. When air is not suctioned, inspired CO(2) levels increase significantly, whereas suctioning prevents this increase. Expiratory CO(2), respiratory rate, heart rate, and arterial blood pressure remain stable regardless of suctioning.

Long-term degeneration and regeneration of the rabbit facial nerve blocked with conventional lidocaine and bupivacaine solutions.

The alterations due to the long‐term degeneration and regeneration of the rabbit facial nerve were investigated. The facial nerve was blocked with conventional lidocaine and bupivacaine solutions. The rabbits were sacrificed and facial nerves were removed 2, 4, 6 and 8 weeks after the administration of normal saline, lidocaine and bupivacaine. The samples were then processed for electron microscopic observation.