Mehmet Sargin

Comparison of McGrath(®) Series 5 video laryngoscope with Macintosh laryngoscope: A prospective, randomised trial in patients with normal airways.

Objective: The McGrath Video laryngoscope is a newly developed video laryngoscope that significantly improves laryngeal view and facilitates endotracheal intubation in difficult airways. However in patients with normal airway that is not mentioned before. The aim of this study was to compare the McGrath video laryngoscope with the Macintosh laryngoscope in patients with normal airways. Methods: A total of 100 patients requiring orotracheal intubation, were randomized to either having intubation with the McGrath video laryngoscope or the Macintosh laryngoscope. The primary outcome was the laryngoscopy view using percentage of glottic opening (POGO) score. Secondary outcomes included Cormack and Lehane grading system, time to intubation, number of failed intubations, number of attempts before successful intubation and hemodynamic parameters during intubation. Results: POGO scores were significantly higher in the McGrath group compared with the Macintosh group (p<0.001) despite time to successful intubation was similar in both groups. The McGrath video laryngoscope provided more Grade-I laryngoscopic views than the Macintosh laryngoscope (p<0.001). Number of more than one attempts in order to achieve success was significantly higher in the Macintosh group (p=0.001). The number of minor complications were significantly higher in the Macintosh group (p=0.004). There were no significant changes in hemodynamic responses between the two groups (p>0.05). Conclusion: McGrath video laryngoscope allows patients with normal airways to achieve higher POGO scores and significantly more Grade-I laryngoscopic views when compared with the Macintosh laryngoscope.

Anxiety Levels in Patients Undergoing Sedation for Elective Upper Gastrointestinal Endoscopy and Colonoscopy

Background: Anxiety is a common preprocedural problem and during processing especially in interventional medical processes. Aim: Aim of this study was to assess the level of anxiety in patients who will undergo upper gastrointestinal endoscopy and coloscopy. Methods: Five hundred patients scheduled to undergo sedation for elective upper gastrointestinal endoscopy and colonoscopy were studied. Beck Anxiety Inventory (BAI) was administered to each patient before brought to the endoscopy room. Demographic data of patients were collected. Results: BAI scores and anxiety levels were significantly lower in; males compared to females, patients with no comorbidity compared to patients with comorbidity (both P values < 0.001). BAI scores were significantly lower in patients educational status university and upper compared to patients educational status primary-high school (p=0.026). There were no significant difference between BAI and anxiety levels compared to procedures (Respectively, P=0.144 P=0.054). There were no significant difference between BAI scores and anxiety levels compared to age groups (Respectively, P=0.301 P=0.214). Conclusions: We think that level of anxiety in patients who will undergo upper gastrointestinal endoscopy and colonoscopy was effected by presence of comorbidities and gender but was not effected by features such as age, procedure type and educational status.

The effects of bispectral index monitoring on hemodynamics and recovery profile in developmentally delayed pediatric patients undergoing dental surgery.

General anesthesia is often preferred for dental surgery or rehabilitation in developmentally delayed pediatric patients. Bispectral index monitoring is used to monitor the depth of anesthesia and to ensure early recovery. However, studies on the topic in developmentally delayed pediatric patients are limited.

Pre-gestasyonel ve gestasyonel periyottaki vücut kitle endeksinin elektif sezaryen operasyonu için spinal anestezi sırasında cilde iğne giriş ağrısına etkisinin değerlendirilmesi

Amac: Spinal anestezi sirasindaki cilde igne giris agrisi, pek cok hastada spinal anesteziden cayma sebebidir. Bu calismada, pregestasyonel ve gestasyonel vucut kitle endeksinin gebelerde sezaryenleri icin uygulanan spinal anestezi sirasinda cilde igne giris agrisini etkileyip etkilemedigini arastirmayi amacladik. Materyal-Metot: Spinal anestezi altinda elektif sezaryen gecirecek 100 gebe calismaya dahil edildi. Spinal anestezi, median yaklasim kullanilarak L3-4 veya L4-5 vertebra seviyesinde oturma pozisyonunda 27G Quincke spinal igne ile hiperbarik bupivakain 10-15 mg ile gerceklestirildi. Spinal anestezi sirasindaki cilde igne giris agrisi, 0 ile 10 arasinda bir olcekte degerlendirildi; buradaki 0, agri ve 10 olasi en kotu agri anlamina gelmektedir. Bulgular: Gestasyonel vucut kitle endeksi ile cilde igne giris agrisi VAS skorlari arasinda bir iliski bulunmadi (ρ = -0.021, p = 0.835). Ayrica gebelik oncesi vucut kitle endeksi ile cilde igne giris agrisi VAS skorlari arasinda da bir korelasyon bulunmadi (ρ = -0.012, p = 0.903). Sonuc: Pregestasyonel ve gestasyonel vucut kitle endeksinin spinal anestezi sirasinda cilde igne giris agrisina herhangi bir etksinin bulunmadigi kanaatindeyiz.

Anidulafungin induced reversible thrombocytopenia in a patient: A case report -

Anidulafungin is a semisynthetic antifungal agent which is an echinocandin. Here, we presented elderly patient developed reversible severe thrombocytopenia due to anidulafungin. A 75-year-old man was admitted to the ICU with signs of hypovolemic shock and acute anemia. Amikacin therapy 15 mg/kg/day was started with the diagnosis of pneumonia due to the growth Acinetobacter baumannii. Amikacin therapy was discontinued in the treatment day 3 and began to colistin 2 mg/kg every 8 hours and imipenem 7 mg/kg every 6 hours. On hospital day 17, fluconazole 200mg/day was added to treatment due to candida albicans growth in blood culture and colistin-imipenem treatment was discontinued in the treatment. Candida albicans produced in control blood culture on floconazole therapy day 5 and the treatment was continued. Because of the increasing procalcitonin and CRP levels, liver enzyme elevation and fever 38.5 Co on fluconazole therapy day 6, anidulafungin therapy 200 mg was switched on fluconazole promptly. The dosage of anidulafungin was continued to 100 mg/day. Platelet counts was found to be six thousands anidulafungin therapy day 4. So treatment was terminated and liposomal amphotericin B treatment was started. Five days after the cessation of treatment with anidulafungin, platelets value was found to be over 100 thousand. Antifungal therapy was discontinued on liposomal amphotericin B therapy day 14, due not to the growth of microorganism in control blood culture. The patient who continue to be treated in intensive care, died due to multiorgan failure at 66 days. In conclusion; clinicians may consider monitoring platelets periodically, particularly in patients with hematologic disorders who use antibiotics and / or antifungal agents.

Hyoscine N-Butylbromide for Preventing Propofol Injection Pain: A Randomized, Placebo-Controlled and Double-Blind Study

Objective: In this study, the aim was to investigate the effect of hyoscine N-butylbromide (HnBB) pretreatment on pain during propofol injection. Subjects and Methods: In this prospective, randomized, placebo-controlled and double-blind trial, 60 patients scheduled to undergo routine outpatient surgery under general anesthesia were randomly allocated to 2 groups, the HnBB (n = 30) and sodium chloride (n = 30) groups. Twenty seconds after the injection of 20 mg HnBB or 0.9 % sodium chloride, a 50-mg dose of propofol was injected in 2–3 s. Ten seconds later, the pain intensity was assessed using a 4-point scale: no pain (0), mild (1), moderate (2), and severe (3) pain. The Student t test was used for the analysis of parametric data and the Pearson χ2 test for categorical data. Results: The occurrence of pain in the HnBB group (43.3%) was significantly lower than the control group (73.3%) (p < 0.018). Of the 30 patients in each group, 10 in the control group and 3 in the HnBB group experienced severe pain (p = 0.001). Conclusions: Pretreatment with 20 mg HnBB significantly reduced propofol injection pain compared to placebo.

The effects of spinal neddle on skin puncture pain during spinal anesthesia for caesarian sections: Comparison of 26G Quincke and 26G atraumatic spinal needles

Aim: Skin puncture pain during spinal anesthesia is the reason of wincing from spinal anesthesia in many patients. In this study we aimed to compare the effect of two different spinal needles on skin puncture pain during spinal anesthesia for caesarian sections. Material and Methods: Eighty pregnant women scheduled to undergo elective caesarean section under spinal anesthesia were studied. Spinal anesthesia was induced with hyperbaric bupivacaine 10-15 mg via a 26G Quincke (Group Q, n=40) or 26G atraumatic (Group A, n=40) spinal needle in the sitting position at the L3–4 or L4-5 vertebral level using median approach. Skin puncture pain during spinal anesthesia was assessed on a scale of 0 to 10, where 0 means refers no pain and 10 the worst possible pain (0 no, 1–3 mild, 4–6 moderate, 7–10 severe). Results: Skin puncture pain VAS values, median (range) [IQR], were 2(1-5)[1-3] in Group Q and 2(1-7)[1-3] in Group A. There were no statistically differences between the groups (p=0.707). Conclusion: We believe that Quincke and Atraumatic spinal needles don’t have any difference in terms of skin puncture pain during spinal anesthesia for cesarean section.

Ultrason Rehberliğinde Bilateral İnfraklaviküler Blok: Olgu Sunumu

Periferik sinir bloklari, genel anestezi gerektirmeyen veya yuksek riskli vakalar icin iyi bir alternatif tekniktir. Vucudun birden fazla bolgesinde bolgesel anestezinin gerekli oldugu durumlarda lokal anestetik dozu arttikca toksisite riski orantili olarak artacaktir. Son yillarda anestetik uygulamalarin cesitliliginde artis ve kliniklerde ultrason gibi tibbi araclara kolay erisilebilirlik, gerekli lokal anestezik dozunda onemli bir azalmaya neden olmustur. Bu makalede, mevcut literatur isiginda bilateral distal radius kiriklari olan bir olguya dusuk doz lokal anestezik ajan kullanilarak uygulanan bilateral infraklavikuler blok olgusu bildirilmistir.

Scalp Block for Burr Holle Evacuation of Subdural Hematoma: A Series of Seven Patients and Review of the Literature

Aim: A scalp block is a good perioperative and postoperative anesthesia/ analgesia method that has become widespread and preferred by many anesthesiologists. Material and Method: The present report presented seven patients, who underwent scalp block due to the evacuation of a subdural hematoma. The demographic features of the patients, sedative agents administered, and local anesthetic agents and the doses preferred for scalp block were specified. All patients were hemodynamically stable in the peri operative period, and none of the patients developed complications. None of the patients developed early or late local anesthetic toxicity. Discussion: Considering the presence of comorbid conditions in this patient population, scalp block provides a more comfortable and safe method compared to general anesthesia for both anesthesiologists and the clinicians that undertake postoperative care of the patients after evacuation of subdural hematoma.

Lujan-Fryns sendromlu bir hastada ameliyathane dışı anestezi

Lujan-Fryns sendromu 1979 yilinda Fryns tarafindan tanimlanan otozomal resesif gecis gosteren multipl konjenital anomali ile karakterize bir sendromdur. Dismorfik yuz hatlari, yarik damak, diyafragma hernisi gibi anestezi pratigini etkileyebilecek bir cok anomali iceren nadir bir sendromdur. Anestezi ve/veya ameliyathane disi anestezi yonetimi ile ilgili literatur bilgisi sinirlidir. Burada Lujan-Fryns sendromlu bir olguda ameliyathane disi anestezi yonetimini literatur esliginde sunmayi amacladik.