Lale Karabiyik

Effects of sevoflurane and/or nitrous oxide on bacterial growth in in vitro culture conditions

The aim of this study was to determine the role of sevoflurane and/or nitrous oxide on bacterial growth under conditions in vitro similar to those of clinical practice. We assessed these effects on Pseudomonas aeruginosa, Acinetobacter lwoffii, and Staphylococcus aureus growth. Bacterial inoculums were prepared from reference strains in nutritive broth. Airtight chambers were filled with bacterial suspensions. Each strain was studied with and without exposure to sevoflurane and/or nitrous oxide at baseline, after 1 and 3 h. Serial dilutions and agar plates were made and the colonies were counted. P. aeruginosa were grown after exposure to the nitrous oxide alone (2.8 × 103 colony-forming units/ml; CFU ml−1) after 3 h according to the control (P < 0.05). A. lwoffii were grown after exposure to the nitrous oxide and sevoflurane with nitrous oxide (8.7 × 103 and 8.0 × 103 CFU ml−1) (P < 0.05), respectively. There were no changes in S. aureus growth in controls and anesthesia groups. We conclude that the effects of anesthetic agents on bacterial growth may change owing to the type of anesthetic and microorganism.

Airway management of a patient with weill-marchesani syndrome

Weill-Marchesani syndrome is a genetically determined rare systemic connective tissue disorder consisting of brachymorphy, brachydactyly, aortic stenosis, and ophthalmologic abnormalities, such as ectopia lentis, microspherophakia, and secondary glaucoma. The primary lesion is fibrous tissue hyperplasia. Airway control and intubation may be difficult in patients with WMS because of stiff joints, poorly aligned teeth, and maxillary hypoplasia with a narrow palate. We describe the successful airway management of a patient with WMS and laryngeal stenosis, using an intubating laryngeal mask following failed conventional laryngoscopic intubation.

Comparisons of the effects of the sevoflurane and propofol on acute ischemia reperfusion and DNA damages in rabbits

BACKGROUND AND OBJECTIVES The aim of this study was to compare the effects of sevoflurane and propofol anesthesia on oxidative DNA damage that occurs in low-extremity ischemia and is caused by tourniquet application. METHODS Fourteen New Zealand rabbits were randomly allocated into two equal groups. Group S (n=7) received sevoflurane (2.5-4 percent) inhalation and Group P (n=7) received a propofol infusion (1-2mg·kg-1·min-1), after which a pneumatic tourniquet was placed on the right lower extremity. Blood samples were collected prior to tourniquet placement (baseline), 120min after ischemia, 15min after ischemia and 120minutes (min) after ischemia. Malondialdehyde (MDA) levels were analyzed to determine lipid peroxidation, and single cell gel electrophoresis (SCGE) was used to determine DNA damage. RESULTS At 15min after ischemia, the MDA levels in Group P (8.15±2.61μM) were higher than baseline (6.26±3.19μM, p=0.026) and Group S (4.98±0.77μM, p=0.01). DNA damage was similar in both groups, although DNA damage was higher than baseline (tail moment 0.63±0.27, tail intensity 3.76±1.26) in Group P at the 15th minute of reperfusion (tail moment 1.05±0.45, p=0.06; tail intensity 5.33±1.56, p=0.01). The increase in tail moment and tail intensity returned to normal levels in both groups 2hours after the termination of ischemia. CONCLUSION Given that oxidative stress and genotoxic effect disappear in the late stages of reperfusion, we conclude that neither sevoflurane nor propofol can be considered superior to the other in anesthesia practices for extremity surgeries involving the use of a tourniquet.

Placement of a double-lumen tube using LMA C Trach and an exchanger catheter in difficult airway intubation -A case report-

During insertion of the double lumen tube in patients with cervical vertebral fixation, the cervical neutral position should be maintained. Although flexible fiberoptic bronchoscopic intubation is the gold standard, novel techniques are needed to facilitate intubation of patients with cervical vertebral fixation in neutral position according to institutional capabilities. In this case report, insertion of the double lumen tube in the neutral position using LMA CTrach and an airway exchanger catheter in a thoracotomy patient with extremely limited head and neck motion due to fixation of the cervical vertebrae is presented.

The Effects of Desflurane on Human Platelet Aggregation In Vitro

In view of the possible antiplatelet effects of general anesthetics, we investigated the in vitro effects of desflurane, a new inhalation agent, on platelet aggregation. For 15 patients who underwent elective operations, blood was sampled with desflurane induction before and after anesthesia but prior to surgery so that platelet aggregation in the drawn blood could be tested before desflurane anesthesia and again after exposure to the anesthetic. Platelet aggregation was measured with a whole-blood aggregometer. Adenosine diphosphate (ADP), collagen, and ristocetin were used as aggregating agents. Our results showed that aggregation in response to ADP, collagen, or ristocetin was not inhibited in patients who received desflurane anesthesia. This study with an in vitro model showed that desflurane had no influence on platelets in clinically relevant doses.