Mahmut Durmuş

Effect of dexmedetomidine on bleeding during tympanoplasty or septorhinoplasty

Background and objective: The aim of this study was to evaluate the efficacy of dexmedetomidine, an &agr;2‐adrenoceptor agonist, on intraoperative bleeding, anaesthetic drug requirement and postoperative pain. Methods: Forty patients scheduled for elective tympanoplasty and septorhinoplasty operations under general anaesthesia were included in the study. The patients were randomly assigned to receive either a dexmedetomidine 1 &mgr;g kg−1 bolus 10 min before induction of anaesthesia plus 0.5 &mgr;g kg−1 h−1 infusions during maintenance or placebo. Mean arterial pressure was maintained between 60 and 80 mmHg. Perioperative mean arterial pressure, heart rate, time to extubation and time to awakening were recorded. Bleeding during surgery was assessed by the surgeon, blinded to the study drugs, both intraoperatively and postoperatively as a final personal opinion about the whole surgical process. Results: The heart rate and mean arterial pressure were significantly lower during induction, operation and extubation in the dexmedetomidine group (P < 0.05). Blood losses were lower in the dexmedetomidine group (P < 0.05). Propofol dose required for induction, and fentanyl and isoflurane consumption were significantly reduced in the dexmedetomidine group (P < 0.05). The total amounts of nitroglycerin and meperidine used were higher in the control group (P < 0.05). Conclusions: Dexmedetomidine decreased bleeding, postoperative analgesic requirements and intraoperative anaesthetic requirements and was associated with more stable haemodynamic responses to anaesthesia. We conclude that dexmedetomidine is a useful adjuvant to decrease bleeding when a bloodless surgical field is requested.

The use of magnesium to prevent laryngospasm after tonsillectomy and adenoidectomy: a preliminary study.

Background: Laryngospasm is the most common cause of upper airway obstruction after tracheal extubation. Magnesium has a central nervous system depressant property, which contributes to the depth of anaesthesia. It also has calcium antagonist properties, which provide muscle relaxation. In this study, we aimed to determine the effect of magnesium on preventing laryngospasm.

The post‐operative analgesic effects of a combination of gabapentin and paracetamol in patients undergoing abdominal hysterectomy: a randomized clinical trial

Background:  The aim of the present study was to compare the effects of a combination of gabapentin and paracetamol with gabapentin alone and placebo on post‐operative pain and morphine consumption.

The effects of pre-operative dexmedetomidine infusion on hemodynamics in patients with pulmonary hypertension undergoing mitral valve replacement surgery

Background:  The aim of this study was to investigate the effects of pre‐operative dexmedetomidine infusion on hemodynamics in patients with pulmonary hypertension undergoing mitral valve replacement surgery.

Cervical subcutaneous emphysema : an unusual complication of adenotonsillectomy

Removal of the tonsils and adenoid tissue because of recurrent infection and/or respiratory obstruction is one of the most commonly performed operations. A rare complication during this intervention is subcutaneous surgical emphysema. The awareness of anaesthesiologists and otolaryngological surgeons will protect the patient from serious consequences. We report our experience with this complication and provide a review of the literature.

The effects of dexmedetomidine on liver ischemia–reperfusion injury in rats

BACKGROUND Ischemia-reperfusion (IR) injury of the liver may cause various types of damage to hepatic tissues. It can affect the prognosis of patients and the success of an operation. Dexmedetomidine is a selective α2 receptor agonist. We investigated whether dexmedetomidine provides protection against IR-induced liver injury in rats. METHODS Forty rats were divided equally into four groups. In group 1, the liver was manipulated after the laparotomy, and no occlusion of the vessels of the liver was performed. In group 2, once the abdomen was opened, 60 min of ischemia and 60 min of reperfusion were applied according to the segmental hepatic ischemia model. In group 3, 10 μg/kg of dexmedetomidine was injected into the peritoneal cavity 30 min before ischemia. In group 4, 100 μg/kg of dexmedetomidine was injected into the peritoneal cavity 30 min before ischemia. Further procedures in groups 3 and 4 were the same as those of group 2. After the experiment was completed, the rats were killed. Liver tissues were removed and stored until biochemical and histologic assessments were performed. RESULTS The malondialdehyde level in group 2 was higher than that of groups 1, 3, and 4 (P = 0.001, P = 0.000, and P = 0.000, respectively). Superoxide dismutase, catalase, and glutathione levels in group 2 were lower than those in group 1 (P = 0.001, P = 0.027, and P = 0.014, respectively). Superoxide dismutase and catalase levels in group 4 were higher than those in group 2 (P = 0.002 and P = 0.000, respectively). GSH levels in groups 3 and 4 were higher than those in group 2 (P = 0.049 and P = 0.006, respectively). A lower glutathione peroxidase level was detected in groups 2 and 3 than that in group 1 (P = 000). Group 4 demonstrated an increase in glutathione peroxidase levels compared with group 3 (P = 0.014). The histologic injury scores in groups 2-4 were higher than those in group 1 (P = 0.003, P = 0.002, and P = 0.001, respectively). However, the histologic injury scores were lower in groups 3 and 4 than those in group 2 (P = 0.003 and P = 0.002, respectively). CONCLUSIONS This study showed that dexmedetomidine may protect the liver against IR injury in rats.

Oral clonidine premedication does not reduce postoperative vomiting in children undergoing strabismus surgery

Background: We evaluated the effect of oral clonidine on postoperative vomiting (POV) in children undergoing strabismus surgery.

Pain, fentanyl consumption, and delirium in adolescents after scoliosis surgery: dexmedetomidine vs midazolam

The study aim was to compare the efficacy of dexmedetomidine vs midazolam for sedation during the early postoperative period in adolescents who underwent scoliosis surgery.

Dexpanthenol pastille and benzydamine hydrochloride spray for the prevention of post-operative sore throat

Background:  In this study, we aimed to compare the effectiveness of dexpanthenol pastille and benzydamine hydrochloride spray on the prevention of a sore throat.

Effects of 2 Different Doses of Pregabalin on Morphine Consumption and Pain After Abdominal Hysterectomy: A Randomized, Double-Blind Clinical Trial

BACKGROUND Pregabalin has a similar pharmacologic profile to that of its developmental predecessor gabapentin but has shown greater analgesic activity in rodent models of neuropathic pain. OBJECTIVE The objective of the study was to compare the effects of 2 different doses of pregabalin and placebo on postoperative pain and morphine consumption. METHODS Ninety patients who underwent abdominal hysterectomy were included in the study and randomly divided into 3 groups in a doubled-blinded manner. They were given 150 mg of pregabalin (group P300, n = 30), 300 mg of pregabalin (group P600, n = 30), or placebo capsules (group C, n = 30) 4 hours before the induction of anesthesia; they received a second dose of the drug 12 hours postoperatively. Morphine consumption, nausea, and vomiting, visual analogue scale-pain intensity (VAS-PI), sedation scores, and dissatisfaction scores were recorded in the postanesthesia care unit (PACU) and at 2, 4, 6, and 24 hours after operation. RESULTS Morphine consumption at 24 hours was 40.80 (3.42) mg, 33.79 (5.77) mg, and 46.97 (6.67) mg in groups P300, P600, and C, respectively (P < 0.001). VAS-PI scores at movement and at rest in the PACU and at 2, 4, and 6 hours decreased in group P600 (P < 0.01). In the PACU and at 2, 4, and 6 hours, the sedation scores were increased in group P600 compared with the scores in group C (P < 0.001, P < 0.001, P = 0.01, P = 0.006, respectively). Patient satisfaction was higher in group P600 than in group C for all time points (P < 0.001, P < 0.001, P < 0.001, P = 0.001, P < 0.001, respectively). There were no statistically significant differences between the groups for side effects such as nausea, vomiting, and dizziness (P = 0.58). CONCLUSIONS Pregabalin at a total dose of 600 mg, administered before operation and at 12 hours postoperatively after abdominal hysterectomy, reduced morphine consumption and pain intensity and increased patient satisfaction. No significant differences in side effects were observed between the study groups.