Yeşim Şenayli

Antioxidant Effects of Propofol on Tourniquet-Induced Ischemia-Reperfusion Injury: An Experimental Study

PURPOSE This experimental study aimed to investigate the antioxidant effects of propofol anesthesia at induction doses in a rat skeletal muscle ischemia/reperfusion injury model. METHODS Twenty-six rats were randomly divided into three groups to receive one of the following interventions: sham operation (n = 6), ischemia/reperfusion (I/R) injury (n = 10), or propofol administration in addition to I/R injury (n = 10). I/R injury was attained by 2-h clamping of femoral artery followed by 3-h perfusion. Then blood and tissue samples were collected for biochemical analysis and histopathologic examination. Glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) enzyme activities and nitric oxide (NO) and malondialdehyde (MDA) levels were measured in both plasma and muscle tissue. In addition, catalase (CAT) activity and protein carbonyl (PC) content were measured in muscle tissue. RESULTS I/R group had significantly higher SOD activity (9.05 versus 5.63 and 6.18 U/mL, P < 0.05) and NO level (46.77 versus 30.62 and 33.90 μmol/L, P < 0.05) compared with sham-operated group and I/R plus propofol group. In addition, GSH-Px activity of the I/R group was significantly higher than sham-operated group (1.26 versus 1.05 U/mL, P < 0.05). I/R group had significantly higher tissue activities of CAT (0.11 versus 0.06 and 0.04 k/g protein, P < 0.05) and SOD (0.12 versus 0.08 and 0.07 U/mg protein, P < 0.05) compared with the sham and I/R plus propofol group. Histopathologic examination showed that I/R plus propofol group had significantly lower degeneration (P = 0.021) and inflammation (P = 0.028) scores compared with I/R group. CONCLUSION Propofol anesthesia seems to enhance the antioxidant capacity against tourniquet induced ischemia-reperfusion injury.

A novel operative technique for concealed penis secondary to penoscrotal web: a case report.

Contemporary surgical techniques for concealed penis defined in the literature are sophisticated and, because of this, we decided to perform a simple technique. A child with penoscrotal web was admitted to our Pediatric Surgery Clinic. The patient had recurrent urinary tract infections without urinary tract disease and, therefore, web reconstruction was thought to be useful. A modified unfurling technique and penoscrotal angle reconstruction was used. The main characteristic of our procedure can basically be described as an oblique incision of the outer foreskin leaf which guides the next steps. We report the operative and clinical course of the patient. We demonstrated that the penoscrotal web was treated simply and effectively as an outpatient procedure. In addition, in the follow-up period, we found that the patient had acceptable and cosmetic penile skin.

Injury of Abdominal Aorta During Laparoscopic Orchiectomy in a Pediatric Patient

ABS TRACT Injury to major vessels during laparoscopic procedures is an emergency intervention situtaiton. Because it may results with death. During the laparoscopic (endoscopic) surgery of a 14-year-old boy child with the diagnosis of non-palpable testis, aortic injury occurred at the time of insertion of first trocar. Deteriorating of hemodynamic parameters perioperatively alarmed the surgical team and immediately open surgery was decided. Invasive monitoring and cathetherization of internal jugular vein were performed. Adequate blood and blood product replacement were performed. Bleeding focus at the abdominal aorta was repaired through median laparotomy. The patient remained stable during postoperative period and was discharged with full recovery. In laparoscopic surgical interventions, it should be remembered that laparoscopic experience of the anesthesia team and close monitoring of hemodynamic parameters perioperatively could ease early recognition of complications, thereby decreasing morbidity and mortality rates.

Evaluation of 865 children who underwent magnetic resonance imaging under propofol-midazolam sedation

Received: 04.08.2017 Accepted: 14.08.2017 Department of Anesthesiology, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey Yazışma adresi: Gülsen Keskin, Department of Anesthesiology, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey e-mail: drgulsenkeskin@gmail.com INTRODUCTION

PEDİATRİK ÜROLOJİK CERRAHİDE KAUDAL EPİDURAL BLOK UYGULAMASI; 5536 OLGU DENEYİMİ

Objective: In pediatric surgery, caudal epidural analgesia is reliable, easy to learn regional anesthesia technique in surgical procedures under the umbilicus. Despite its frequent use, excellent analgesic properties, current literature search yielded only a few large series reported. We aimed to present our institutional experience reflecting the collective data in pediatric urological surgical casesMateials and Methods: The anesthesia records of 5536 consecutive pediatric urological surgical cases who underwent caudal epidural anesthesia procedure between January 2008-February 2013 were retrospectively analyzed. Parameters including the type of surgery, demographic findings, need for additional analgesic agents, the complications related to the procedure, the percentage of failed cases were analyzed.Results: Total patients with a median age of 4 years were enrolled. There were 4538 male (82%), 998 female (18%) patients. In four cases the procedure was terminated due to dural puncture. Inadvertent penetration of vascular space was noted in 276 (4,98%) cases. In 221 cases, it was terminated due to the failure of correct placement of the needle despite repeated attempts. The procedure was categorized as failure in 122 (2,2%) cases. 4096 patients were discharged on the same day. In 48 patients (1,5%) additional analgesic dose was needed. In the patients who required prolonged hospitalization additional analgesic was started at postoperative 6th hour.Conclusion: Caudal epidural anesthesia is easy, safe and effective technique in preoperative and postoperative pain control.. The main advantages are high success, low complication rates, lesser analgesic dose requirement. In the light of our study results, we recommend routine use of the caudal epidural procedure in pediatric urological surgery cases