Zeynep Baysal

Oxidative status and DNA damage in operating room personnel.

OBJECTIVES The aim of this study was to investigate the effects of occupational exposure to anesthetic gases on peripheral mononuclear leukocyte DNA damage and oxidative status in operating room personnel. DESIGN AND METHODS The population of study includes 30 operating room personnel (Group I) and 30 non-operating room personnel for control groups (Group II). DNA damage was assessed by alkaline comet assay in peripheral lymphocyte. Plasma levels of total antioxidant status (TAS), total oxidative status (TOS) were determined by using a novel automated measurement method and oxidative stress index (OSI) was calculated (OSI was calculated as: OSI=(TOS/TAS)x100). RESULTS Mononuclear leukocyte DNA damage, plasma TOS and OSI were significantly higher in Group I than Group II [p<0.01, p<0.05, p<0.05 respectively]. There was also significantly decrease in plasma TAS in Group I than Group II [p<0.05]. There were positive significant correlations between DNA damage and TOS and OSI in Group I [r=0.84, p<0.001, r=0.89, p<0.001 respectively]. CONCLUSIONS Our findings demonstrate that, mononuclear leukocyte DNA damage was significantly higher in operating room personnel. The increase of DNA damage might depend on oxidative effects of anesthetics.

Oral sedation with midazolam and diphenhydramine compared with midazolam alone in children undergoing magnetic resonance imaging

Background:  The purpose of this study was to compare the safety and efficacy of oral midazolam and midazolam–diphenhydramine combination to sedate children undergoing magnetic resonance imaging (MRI).

Remifentanil vs alfentanil in the total intravenous anaesthesia for paediatric abdominal surgery

Summary Backgrounds: Our aim was to investigate whether total intravenous anaesthesia (TIVA) with remifentanil and alfentanil would ensure appropriate analgesia and recovery conditions in anaesthesia for children undergoing abdominal surgery.

Evaluation of total oxidative and antioxidative status in pediatric patients undergoing laparoscopic surgery

OBJECTIVE Reactive oxygen species (ROS) induced by several diseases can trigger oxidative stress. During laparoscopy, increased intraabdominal pressure caused by pneumoperitoneum may lead to splanchnic ischemia followed by reperfusion because of deflation. Because ischemia reperfusion creates oxidative stress, in this study, we aimed to investigate the oxidative-antioxidative status of the pediatric patients with laparoscopic surgery. METHODS The children underwent laparoscopic procedures under general anesthesia, and they were mechanically ventilated. Blood samples were obtained after induction of anesthesia, at the end of the surgery, and were centrifuged at 3000 revolutions per minute for 10 minutes to separate plasma. The plasma total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) were determined. RESULTS Plasma TOS and OSI levels were significantly higher at the end of the surgery than after induction of anesthesia (P < .05 and P < .01, respectively). On the other hand, plasma TAS levels were lower in the end of the surgery than after induction of anesthesia (P < .05). CONCLUSIONS These results suggest that ROS are generated during the laparoscopic procedure, possibly as a result of an ischemia-reperfusion phenomenon induced by the inflation and deflation of the pneumoperitoneum, which causes oxidative stress and consume plasma antioxidants.

Intraoperative perineural infiltration of lidocaine for acute postlaminectomy pain: preemptive analgesia in spinal surgery.

Study Design Prospective, cohort, and clinical study. Summary of Background Data It was proven that effective control of postoperative pain in lumbar disk surgery improves the patients recovery. Despite the many advances in surgical and nonsurgical techniques, the most accurate approach in pain relief is still under debate. Objective In this study, our aim was to determine whether neural root blockade before the onset of noxious stimuli could inhibit the production of pain. Methods Forty-five patients undergoing unilateral 1 spinal level (lumbar 5) hemipartial laminectomy were included in the study. In 20 of the patients (group 2), 0.5 mL 2% lidocaine was infiltrated onto the neural root immediately after the exposure; the 25 patients in the control group (group 1) were not injected. All patients were monitored regarding pain determination using a visual analog scale, and the exact time of analgesic requirement during the first postoperative day was noted. Total analgesic dose given during the first postoperative day was also recorded. Results Perineural lidocaine infiltration extended the early postoperative analgesic period. Although the pain was not completely suppressed, the lidocaine infiltration helped to manage the postoperative pain more effectively. The patients (group 2) who received lidocaine infiltration intraoperatively onto the neural root had a statistically significant longer time before analgesia requested (P<0.001) and also required significantly less analgesic when compared with the control group (P<0.001). Conclusions For preemptive analgesia for acute postoperative pain in laminectomy surgery, which remains a major concern, we suggest that lidocaine infiltration onto the dorsal neural sheath immediately before retraction of the root may extend the time before analgesia requested and the total analgesic drug consumption.

Opioid Analgesia for Hysterosalpingography: Controlled Double-Blind Prospective Trial with Remifentanil and Placebo

Background/Aims: A hysterosalpingogram is an integral part of the evaluation of infertility, however, it is often painful. Methods: We conducted a randomized double-blinded, placebo-controlled trial of intravenous infusion of remifentanil in women undergoing hysterosalpingography (HSG). We randomly allocated 62 patients scheduled for HSG to receive either a continuous infusion of 0.25 µg·kg–1 of remifentanil or placebo. The degree of pain was documented via 10-cm visual analog scales (VAS). Patients’ discomfort, side effects and recovery times were also recorded. Results: The VAS scores during HSG were 1.25 ± 1.31 in the remifentanil group and 4.78 ± 1.7 in the placebo group (p < 0.001). There were more patients in the remifentanil group that rated their condition as excellent (p < 0.001). The groups did not differ with regard to the incidence of side effects. The recovery times were found statistically longer in the remifentanil group (14 ± 5 vs. 10 ± 3 min). All the patients were discharged 30 min after the procedures without any side effects. Conclusion: Remifentanil infusion during HSG is superior to placebo for relief of pain with minimal opioid side effects.

Effect of ephedrine on the onset time of succinylcholine

Background:  The aim of this study was to evaluate the effect of ephedrine administered prior to induction of anaesthesia on the onset time of succinylcholine for endotracheal intubation.

Intraoperative supratentorial epidural haematoma during removal of a huge posterior fossa dermoid cyst.

Epidural haematomas may occur following cranial operations, and most of them are located near the craniotomy or burr-hole areas. There are very few cases of supratentorial epidural haematoma following the resection of giant tumours located in the posterior fossa. In this case report, we present a patient who developed an acute left temporoparietal epidural haematoma in the perioperative period during the excision of a huge dermoid cyst in the posterior fossa.