Yakup Aksoy

The importance of perfusion index monitoring in evaluating the efficacy of stellate ganglion blockage treatment in Raynaud’s disease

ABSTRACT Stellate ganglion blockage (SGB) is a method used for treating Raynaud’s phenomenon (RP). This study primarily aimed to determine whether the perfusion index (PI) can be used an alternative to Horner’s signs in evaluating the efficacy of SGB in patients diagnosed with RP. In a total of 40 patients, aged 18–65 years and diagnosed with primary RP, SGB was applied for 5 days on the same side with the 2-finger method, using 6 mL of 5% levobupivacaine at the 7th cervical vertebra level. The PI values were recorded from the distal end of the 2nd finger of the upper extremity on the side applied with the block at baseline and at 5, 15, 30, 60 and 120 min. The onset time of Horner findings was recorded. The PI values and visual analogue scale (VAS) pain scores were recorded pre-treatment and after 2 weeks.When the PI values of the 40 patients were examined, a 62.7% increase was observed from baseline to the first session at 5 min (p < 0.05). When all sessions were evaluated, a statistically significant increase was determined in the PI values measured at 5, 15, 30, 60 and 120 min compared with the baseline PI values. There was a statistically significant decrease in the post-treatment VAS pain scores and a statistically significant increase in the post-treatment PI values (p < 0.05). By eliminating peripheral vasospasm with the application of SGB in patients with RP, the distal artery blood flow and PI are increased. PI measurement is a more objective method and therefore could be used as an alternative to Horner findings in evaluating the success of SGB. PI is a non-invasive and simple measurement and also an earlier indicator in evaluating the success of SGB than Horner’s signs.

Anesthetic Management of Lumbar Suturing as Regional Folk Beliefs

Bel ağrısı özellikle gelişmiş ve gelişmekte olan ülkelerde önemli bir ağrı nedeni olup ciddi fiziksel, psikolojik ve ekonomik kayıplara yol açmaktadır (1). Çok sık görülmesinin yanında halen tedavisinde bir standardizasyon sağlanamamıştır. Bundan ötürü tedavide problemler olabilmektedir (2,3). Bu durum hastaların zaman zaman geleneksel ve yöresel inanışlara başvurmasına sebep olmaktadır. Nadir olmakla birlikte ülkemizde de bu tip olgulara rastlanılmaktadır (4). Zeytinyağı ile masaj yapılması, keçi veya koyun derisi ile beli sarma, çiğ balık bağlama, bardak çekme, bele sülük salma, bel çektirme veya bel çiğnetme gibi yaklaşımlar bunlardan bazılarıdır (5). Bu tür durumlar hastaya tıbbi yaklaşımı da değiştirebilmektedir. Olgumuzda anestezi şekli olarak rejyonal (spinal) anestezi düşünülürken lomber bölgede lokal enfeksiyona sebebiyet veren düğüm atılmış ip olması nedeniyle genel anestezi planlanmıştır. Bu durum hastaya uygulanabilecek anestezi yöntemlerini sınırlandırmakla birlikte genel anestezi uygulanması hastanın hastanede kalış süresini ve verilen ilaç sayısını arttırarak hastane maliyetlerinin artmasına sebep olmaktadır.

Acute Intoxications Admitted to Intensive Care Unit: Retrospective Evaluation

1Selahaddin Eyyubi Devlet Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, Diyarbakır 2Selahaddin Eyyubi Devlet Hastanesi, Kulak Burun Boğaz Kliniği, Diyarbakır 3Diyarbakır Eğitim ve Araştırma Hastanesi, İç Hastalıkları Kliniği, Diyarbakır 4Trabzon Of Devlet Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, Trabzon 5Diyarbakır Bismil Devlet Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, Diyarbakır 6Diyarbakır Egitim Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, Diyarbakır

Effect of Anaesthesia Method on Preoperative Anxiety Level in Elective Caesarean Section Surgeries

OBJECTIVE In this study, the effect of the anaesthesia method on preoperative anxiety in parturients scheduled to undergo elective caesarean surgery was investigated. METHODS After Dicle University Ethics Committee approval, 100 American Society of Anesthesiologists (ASA) II parturients, aged between 18 and 45 years, were included in this study from 2011 to 2012 at the Dicle University Faculty of Medicine, Department of Anaesthesiology. The parturients were divided into two groups, with 50 patients in each group: general anaesthesia (GA) and spinal anaesthesia (SA). Patients were evaluated during the preoperative visit. Demographic data and STAI TX-1 form to measure preoperative anxiety were recorded. RESULTS There were no significant differences between the two groups in maternal age, gestational age, level of education and number of children (p>0.05). The average anxiety score was significantly higher in the SA group than in the GA group (p<0.05). CONCLUSION In conclusion, spinal anaesthesia is associated with a higher preoperative anxiety level than general anaesthesia in obstetric patients. Therefore, it is necessary to take prevention against preoperative anxiety for the patients undergoing caesarean section surgeries under spinal anaesthesia.

Lornoxicam use to reduce the pain associated with propofol injection

ABSTRACT Aim: To investigate the efficacy of lornoxicam in the prevention of the pain associated with propofol injection. Material and method: Approval for this study was granted by the ethics committee of our hospital. Using a computer randomisation software, 120 patients undergoing elective surgery were assigned to four equal groups. In Group I (control group), immediately before anaesthesia induction, 10 ml of isotonic 0.9% NaCl solution (placebo) was administered intravenously (IV). In Groups II, III and IV, the same injection contained 2 mg, 4 mg and 8 mg of lornoxicam respectively. A tourniquet was then applied to the forearm for two minutes. Pain evaluation was made using a verbal pain score. Results: Differences in pain severity scores were statistically significant between Groups I and II, Groups I and III, Groups I and IV and between Groups II and III (p < 0.05). However, no significant difference was determined between Groups III and IV (p = 0.401). Conclusion: In all groups administered with lornoxicam, there was a significant reduction in the severity of pain associated with propofol injection, in comparison with the control group. Maximum effect is obtained with a dose of 4 mg.

Caudal Epidural Steroid Injections in Discojenic Pain: Review Article

Introduction: Epidural steroid injections (ESIs) have been widely used for over 50 years in the treatment of back pain with or without radiculopathy. In this study we aimed to evaluate the effects of caudal epidural steroid injections (CESIs) in patients suffering from discogenic pain, resistant to conservative medical therapy. Methods: Systematic review of 270 CESIs performed patients data ’suffering from discogenic pain from January to December 2016 were evaluated. The pain’s exact region was marked as left, right, and bilateral. Patients who had operated before were recorded.According to the source of the discogenic pain, patients were divided into two like; upper lumbar pain (L1-4), lower lumbar pain (L4-S1). Visual analogue scale (VAS) values were recorded before the injection, after the injection and at 1, 3, 6th months during the control visits. Results: A total of 270 patients with discogenic pain were included in the study. 172 of them were male (63.7 %), while 98 of them female (36.3%). VAS scores in all recorded times after injection were found significantly lower compared the values of preinjection (p < 0.05). VAS values in Pain Group L4-S1 were found lower than Pain Group L1-4 for all recorded times. According to the regions of pain, VAS values didn’t differ. VAS scores compared between the patients operated before and the nonoperated patients didn’t differ significantly. Discussions: CESIs are effective in patients suffering from discogenic back pain resistant to conservative and medical therapy. It is a safe and effective method with low complication rates. *Corresponding author: Ebru Tarıkçı Kılıç, Ümraniye, Training and Research Hospital Department of Anaesthesiology and Reanimation, İstanbul, E-mail: ebru.tarkc@yahoo.com