Serkan Karaman

The McGrath Series 5 video laryngoscope versus the Macintosh laryngoscope: a randomized trial in obstetric patients

BACKGROUND/AIM Anesthesiologists have encountered various difficulties in securing the airway. Therefore, we compare the intubation times and hemodynamic changes between the McGrath Series 5 video laryngoscope and the Macintosh laryngoscope. MATERIALS AND METHODS A total of 80 obstetric patients were divided into 2 groups, orotracheally intubated with either the McGrath video laryngoscope or the Macintosh laryngoscope. The intubation times, Cormack-Lehane grade, percentage of glottic opening, mean arterial blood pressure, and heart rates were compared among the groups. RESULTS Intubation time in the McGrath video laryngoscope group was significantly longer than in the Macintosh laryngoscope group (P <0.01). The percentage of glottic opening was found to be higher in the McGrath video laryngoscope group (P = 0.002). CONCLUSION The McGrath Series 5 video laryngoscope provides excellent views during orotracheal intubation in obstetric anesthesia with normal airways.

The Role of Pain Catastrophizing Score in the Prediction of Venipuncture Pain Severity

In addition to the influence of tissue damage, the intensity of pain is also related to individual cognitive factors. The Pain Catastrophizing Scale (PCS) is used to measure individual tendency toward pain by inquiring about a subjects cognitive characteristics. Building on the knowledge that the venipuncture process causes severe pain and anxiety in some patients, the objective of this study was to investigate the relationship between the PCS score and venipuncture pain.

Central nervous system toxicity after acute oral formaldehyde exposure in rabbits: An experimental study

Formaldehyde (FA) is one of the most widely used chemical compounds in industrial field. It is described as toxic, particularly to the nervous system, the urogenital system, and the respiratory tracts. In this study, we determined the effects of acute oral exposure to FA in rabbit brain tissue. A total of 16 rabbits were selected and divided into 2 groups: formaldehyde group (group F) and control group (group C). FA was administered to group F at a rate of 40 mg/kg/day via a nasogastric tube for 5 days. Saline was similarly administered to the eight controls. All the animals were euthanized after 5 days of exposure, and brain tissue samples were collected in 10% neutral formalin and embedded in paraffin. To investigate the effects of FA on the apoptotic process, we examined active caspase-3, Bax, and Bcl-2 immunohistochemical expression and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate –biotin nick-end labeling (TUNEL) reactivity in the rabbit brains. In addition, glial fibrillary acidic protein (GFAP) was biochemically assessed in brain tissue samples for neurotoxicity. We found that FA treatment caused a significant decrease in Bcl-2 expression and an increase in active caspase-3 and Bax expressions as well as an increase in the number of TUNEL-positive apoptotic cells. The GFAP level was found to be significantly higher in group F. In conclusion, acute oral exposure to FA caused DNA damage, apoptosis, and neuronal injury in the rabbit brains.

Retrospective Evaluation of Anesthesia Approaches for Lumbar Disc Surgery

Objective: Lumbar spinal surgeries have been performed with either spinal or general anesthesia. In this study, we aimed to evaluate the superiority of either spinal or general anesthesia on one-level lumbar discectomies. Methods: After approval of Ethics Committee, we retrospectively analysed 328 patients those administered either spinal or general anesthesia for elective one-level lumbar discectomies over a two-year period. Patient records were reviewed to obtain demographic features, type of anesthesia, baseline heart rate, mean arterial pressure, intraoperative maximum heart rate and mean arterial pressure, duration in the operating room, amount of intravenous fluids, estimated blood loss, incidence of perioperative complications such as bleeding, nauseavomiting, hypotension and bradycardia, and postoperative analgesic consumption. Results: Patient characteristics including baseline/intraoperative mean arterial pressure and heart rate values did not differ between groups. However, the spinal anesthesia group experienced significantly shorter durations in the operating room and had a lower incidence of nausea-vomiting (p = 0.002 and p < 0.01, respectively). Analgesic comsumption in general anesthesia group was significantly higher than in spinal anesthesia group (p < 0.01). Conclusion: The present study revealed that spinal anesthesia is an effective alternative to general anesthesia in lumbar spinal discectomy.

Intraocular pressure changes: the McGrath video laryngoscope vs the Macintosh laryngoscope; a randomized trial

STUDY OBJECTIVE To determine the effects of the McGrath Series 5 video laryngoscope on intraocular pressure (IOP) during laryngoscopy. DESIGN Prospective, randomized, double blind. SETTING Operating room. PATIENTS Eighty adult patients of American Society of Anesthesiologist physical status 1 scheduled for nonophthalmic elective surgery under general anesthesia. INTERVENTIONS The endotracheal intubation was provided using McGrath series 5 video laryngoscope in MG group (n=40) or Macintosh laryngoscope in M group (n=40). MEASUREMENTS The IOP of the right and left eyes was measured before and after the laryngoscopic process. MAIN RESULTS The mean arterial blood pressure values just before laryngoscopy and intubation and after intubation were 77.38±6.18 and 97.38±12.77 in the McGrath video laryngoscope group and 75.85±7.88 and 99.12±14.30 in the Macintosh laryngoscope group, respectively. The IOP values of the left eye after intubation and at the 5th and the 10th minutes in the Macintosh laryngoscope group were found to be significantly higher than those in the McGrath video laryngoscope group (P=.019, P=.019, and P=.007, respectively). In addition, the IOP values of the right eye were found to be higher after intubation and at the 5th and the 10th minutes in the Macintosh laryngoscope group, compared to the McGrath video laryngoscope group (P=.009, P=.021, and P=.011, respectively). The mean IOP values for the left eye just before laryngoscopy and intubation and after intubation were 10.65±2.52 and 15.57±3.62 in the McGrath video laryngoscope group, and for the right eye, they were 10.60±1.64 and 17.17±2.38 in the Macintosh laryngoscope group, respectively. CONCLUSION The McGrath Series 5 video laryngoscope may provide a lower IOP level compared to the Macintosh laryngoscope in an otherwise healthy, young patient population.

Evaluation of effects of repeated sevoflurane exposure on rat testicular tissue and reproductive hormones

Abstract Context: Evaluation of inhalation anesthetics on sperm and reproductive hormones are extremely important. Objective: Investigation of the effects of sevoflurane used as an inhalation anesthetic on sperm morphology and reproductive hormones in rat testes. Materials and methods: Forty Wistar-Albino male rats were divided into five groups of eight rats each. The control group received 2 L/min oxygen for seven days, 2 h/day while sevoflurane treatment S1 received 1 minimal alveolar concentration (MAC) sevoflurane + 2 L/min oxygen for seven days, 2 h/day, and sevoflurane S2 received 1 MAC sevoflurane + 2 L/min oxygen for seven days, 2 h/day followed by seven days of no treatment. Sevoflurane treatment S3 received 1 MAC sevoflurane + 2 L/min oxygen for 14 days, 2 h/day and sevoflurane treatment S4 received 1 MAC sevoflurane + 2 L/min oxygen for 14 days, 2 h/day, with no treatment for the following seven days. All rats were examined histologically after experimental procedures. Rat luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T), and inhibin levels were measured. Results: Histological injury scores were significantly higher in S2, S3, and S4 receiving sevoflurane in comparison to the control group (p = 0.001, <0.001, and 0.001, respectively). Sperm motility and concentration decreased in S3 and S4 compared to the control group (p = 0.03 and 0.02, respectively). Significant differences were detected among all groups for serum LH, FSH, T, and inhibin serum concentrations (p < 0.05). Conclusion: Testicular and sperm morphology, and reproductive hormones were affected by chronic exposure to sevoflurane. However, more randomized, controlled, and well-designed clinical studies with larger population are needed to confirm of these results.

Laparoskopik bariatrik cerrahide anestezi yönetimi: 3 yıllık uygulamada perioperatif komplikasyonlar ve sonuçlar

Objective: In this study, we aimed to assess the perioperative and postoperative results of the patients who underwent bariatric surgery. Methods: After obtaining approval, a retrospectively designed observational study was conducted. All adult patients who underwent laparoscopic gastric plication, sleeve gastrectomy, or roux-en-Y anastomosis between January 2011 and May 2013 were included. Results: A total of 104 patients were included in the study period: 49 (47.1%) underwent laparoscopic roux-en-Y anastomosis, 44 (42.3%) underwent laparoscopic sleeve gastrectomy, and 11 (10.6%) underwent laparoscopic gastric plication. The present study showed a mortality rate of 1.9% (n = 2, one after Roux-en-Y anastomosis operation, and the other one after gastric plication). Conclusion: The anesthesia methods and approaches have no association with morbidity and mortality in such procedures of bariatric surgery indicated in the present study. J Clin Exp Invest 2014; 5 (2): 200-205

Palatal perforation with McGrath Series 5 videolaryngoscope

To the Editor: A healthy pregnant patient (height 166 cm, weight 80 kg) who had an adequate preoperative fasting period was taken into the operating room to undergo an elective cesarean section. Induction of anesthesia was provided with thiopental sodium 5 mg/kg intravenously (IV) and rocuronium bromide 0.6 mg/kg IV. Direct laryngoscopy using a Macintosh 3 blade provided a Cormack–Lehane (CL) grade 3 glottic view. Tracheal intubation failed even when the head and neck were repositioned. A McGrath Series 5 videolaryngoscope (MGS-5; Aircraft Medical Limited, Edinburgh, UK) was used to see the glottis. However, no view was obtained from the first attempt. Nevertheless, intubation was successful during the second attempt, under a CL 2 view, with a styletted 7.5-mm endotracheal tube bent 60 upward just proximal to the cuff according to the angle of the blade. The tip of stylet did not protrude beyond the tube. After removing the MGS-5 from the mouth, blood was seen on the back side of the blade. A direct view of the oral cavity revealed bleeding on the right side of the soft palate. Perforation of the right palate was found, which was repaired by an otorhinolaryngologist during the cesarean section (Supplementary Fig. 1). The patient recovered completely. The exact cause why the tube or the blade of MGS-5 caused right palate perforation was not clearly identified. The MGS-5 is a portable device that provides a better glottic view compared to conventional laryngoscopy and is an alternative to difficult or failed direct laryngoscopy [1, 2]. Besides the existence of palatal injuries using a GlideScope videolaryngoscope, there has been only one case report indicating palatal perforation associated with MGS-5. In their report, the authors concluded that injury occured during tube placement within the blind period of intubation process [1]. This case demonstrates that keeping direct visual contact with the blade of MGS-5 and the tip of tube while inserting it into the oral cavity may minimize the risk of palatal injury.

Comparing efficiencies of diclofenac sodium and paracetamol in patients with primary dysmenorrhea pain by using Visual Analog Scale/Primer dismenore agrili hastalarda diklofenak sodyum ve parasetamol tedavi etkinliklerinin Vizuel Analog Skala kullanilarak karsilastirilmasi

OBJECTIVES The aim of this study was to compare the efficiency of diclofenac sodium to paracetamol using a visual analog scale in the patients presenting to the emergency room with primary dysmenorrhea. METHODS Group I (n=40) patients were diagnosed with primary dysmenorrhea and treated with paracetamol (1 gr intravenous) and Group II (n=40) patients were diagnosed with primary dysmenorrhea and treated with diclofenac sodium (75 mg intramuscular). In both groups, patients were 19-30 years old. In all groups, the intensity of the pain was ranked from 0 (no pain) to 10 (intolerable) using VAS. The VAS scores were compared between treatment groups. RESULTS Between two groups, there was no statistically significant difference in age, mean arterial pressure and pulse values. The initial VAS values of the first group were higher than that of 2nd group. Following treatment, in the 10th and 30th minutes, the VAS values were lower in Group I than Group II (p=0.00). The VAS values of each group were significantly different from each other on the 10th and 30th minutes. VAS values at the 10th and 30th minutes were lower compared to the initial values and the values in the 30th minute were lower relative to the 10th minute (p=0.00) in both treatment groups. CONCLUSION We can suggest that paracetamol is more efficient than diclofenac sodium in the treatment of primary dysmenorrhea.

Compare the Analgesic Effectiveness of Diclofenac and Paracetamol in Patients with Renal Colic

1 1Murat Ayan, 2Erkan Sogut, 3Ufuk Tas, 4Fikret Erdmir, 5Serkan Karaman, 5Semih Arıcı, 1Mehmet Esen, 1Acil Tıp Anabilim Dalı, 2Biyokimya Anabilim Dalı, 3Anatomi Anabilim Dalı, 4Üroloji Anabilim Dalı, 5 Gaziosmanpaşa Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Tokat, Türkiye Kolik Ağrısında Analjezik Etkinlikleri / Efficacy of Analgesics in Colic Pain Compare the Analgesic Effectiveness of Diclofenac and Paracetamol in Patients with Renal Colic