Nureddin Yuzkat

Thiopenthal for Propofol Related Extrapyramidal Movements: Case Report

Propofol is frequently used in outpatient anesthesia practice by anesthetists because it is fast-acting and wears off quickly with the patient regaining consciousness soon after usage, but also it has some side effects. One of them is tonicclonic or involuntary jerking epilepsy. This can present itself as movements when propofol is used or for a period of time afterwards. This is a rarely seen side effect, but it can take time to get these movements under control. Treatment with benzodiazepines is recommended for these abrupt movements, but they may be ineffective in some cases. In our case, the extrapyramidal movements continued despite the use of midazolam and were stopped successfully using thiopental therapy.

Femoral-Sciatic Nerve Block in a Patient with Von Willebrand's Disease: A Case Report

Von Willebrand hastalığı, vWf eksikliği veya fonksiyon bozukluklarına bağlı görülen otozomal geçişli bir kalıtsal kanama diyatezidir (1). vWh en sık görülen kalıtsal kanama diyatezlerinden biridir. Toplum taraması ile elde edilen insidans rakamları %1 dolayındadır (2). vWh, tipik olarak hafif veya orta şiddette deri mukoza kanamalarıyla karakterizedir. Sık görülen semptomlar, deride kolay ekimoz oluşması, burun kanaması, diş eti kanaması, menoraji, postpartum kanamalar, yüzeyel kesilerden sonra uzun süren kanamalar ve GIS kanamalarıdır. Kanamanın şiddeti vWf’nin düzeyine ve fonksiyon bozukluğu olup olmadığına göre farklılık gösterir (3). Bu sunuda koagulopatili bir olguda peroperatif koagulasyon faktörleri verilerek, USG eşliğinde başarılı bir periferik blok uygulaması sunulmuştur. Olgu Sunumu

The Management of Spinal Anesthesia in a Patient with Advanced Kyphoscoliosis and Cardiac Arrhythmia

Kifoskolyoz yaşla birlikte artan progresif bir hastalıktır. Gelişimsel vertebra bozukluklarının neden olduğu spinal bir segmentin arkaya ve yanlara anormal açılandığı sık görülmeyen bir deformitesidir (1). Bu hastalarda kardiyopulmoner fonksiyonlarda, nörolojik defisit ve yürüme güçlüğü gibi deformiteye bağlı etkilerle önemli bozulmalar görülebilmektedir. Kifozskolyoz, anestezi uygulamaları sırasında entübasyon güçlüğüne ve rejyonel girişim tekniklerinin zorlaşmasına neden olmaktadır (2,3). Bu yazıda, ileri derecede kifoskolyozlu, sol femur başında kırık nedeniyle opere edilen kadın olguda uyguladığımız spinal anestezi deneyimimizi sunmayı amaçladık.

The efficiency of hemodialysis in transfusion-related acute lung injury (TRALI): A case report

Transfusion-Related Acute Lung Injury (TRALI) is an important life-threatening complication that is related with blood transfusion. The frequency is reported as 1/5.000. Nearly 70% of the cases need mechanical ventilation, and the mortality of TRALI is around 8-9% (1). It is generally characterized with hypoxia that appears at the 26th hours after the blood transfusion, bilateral infiltration in the chest radiography, and noncardiogenic pulmonary edema (2). Acute respiratory distress, hypotension, tachycardia and fever accompany the clinical picture (3). Past surgery, blood transfusion, and sepsis are among the factors that trigger the disease (4). TRALI is defined as the endothelial damage of the lungs and its pathogenesis has not been explained fully yet. However, it is considered that the granulocyte antibodies in the donor plasma, active neutrophil human leukocytes antigen-1 (HLA)-1, HLA-2 antibodies are intermediaries in the pathogenesis (5,6). It has also been reported that biologically active lipids like lisophosphateidilcholine have also roles in the development of TRALI (7). In this study, the efficiency of the hemodialysis applied in the right time in the treatment of a heavy TRALI case developed after a blood transfusion has been presented. Case report

The analysis of adult intoxication cases seen in Adıyaman Region and treated in intensive care unit

Objective : We determined the patient profile and aim to look into the distribution of age and sex, intoxication route, the duration of the stay in ICU and prognosis of the cases we accepted to our ICU presenting with intoxication. Material and Methods : Before the research, approval was granted by the Ethical Committee. 259 intoxication patients, accepted and treated in the ICU of Adiyaman University Hospital between the dates of 2012-2014, were included in the research. Results: Total of 259 as 83 male, 176 female patients were examined. 75.7% of the cases were below age of 30. 92% of the cases received in ICU were suicidal and 8% of them were accidental intoxication cases. When the causes were observed, 85.7% of the cases were intoxicated by drug intake. Most frequently used drugs were antidepressants (43.6%). The mean number of the days in intensive care unit was 2.02 days. Conclusion: As a result, most of the intoxication cases in intensive care unit were made up by young age cases who received antidepressants with suicidal intentions. Acute drug intoxications have better response to intensive care treatments and shorter duration of stays while non-pharmacological intoxications have longer duration of stays.