Ziya Kaya

The effectiveness of steroids for edema, ecchymosis, and intraoperative bleeding in rhinoplasty.

Background The aim of this study was to investigate the dose-related effectiveness of steroids on periorbital edema, ecchymosis, and intraoperative bleeding in patients who underwent open rhinoplasty with osteotomy. Methods Forty patients were divided into three groups: those in group 1 (n = 15) were given a single dose of 1-mg/kg intravenous (i.v.) methylprednisolone, those in group 2 (n = 15) were given a single dose of 3-mg/kg i.v. methylprednisolone preoperatively, and group 3 (n = 10) was the control group. Eyelid edema and periorbital soft-tissue ecchymosis were evaluated separately using a scale of 0–4. Results In groups using the steroid preoperatively, periorbital edema and ecchymosis were significantly lower compared with the control group (p < 0.05). No significant differences were seen clinically or statistically in preventing or reducing either the periorbital ecchymosis or the periorbital edema between groups 1 and 2. Also, there was no significant difference among the groups in terms of bleeding (p > 0.05). No complications with regard to the operation or steroid use were observed. Conclusion Our results support that steroids significantly decrease periorbital ecchymosis and periorbital edema in open rhinoplasty with osteotomy. Additionally, our results suggest that if the dose of steroids is adjusted according to body weight, there is no significant benefit in a single dose of 3 mg/kg of methylprednisolone over a lower dose of 1 mg/kg and there is no need for higher doses of methylprednisolone administration.

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.

Comparison of Three Different Analgesic Protocols During Shockwave Lithotripsy

BACKGROUND AND PURPOSE Shockwave lithotripsy (SWL) is one of the most important treatment modalities for urinary stone disease. The procedure may cause pain, and patient relaxation and cooperation are crucial in maintaining stone localization for optimal fragmentation and patient comfort during the procedure. As yet, there is not a standard analgesic protocol for patients undergoing SWL. We aimed to use three different analgesic agents and compare their efficacy during SWL in this study. PATIENTS AND METHODS Written informed consents were obtained from 95 patients with kidney stones, and they were randomized to receive lornoxicam (group L, n=32 patients), paracetamol (group P, n=31 patients), and tramadol with a patient-controlled analgesia device (group T, n=32 patients). All groups received patient-controlled analgesia with tramadol during the SWL procedure. The intensity of pain was evaluated with a visual analog scale (VAS). RESULTS The mean age of the patients was 41.87 ± 16.53 years, 44.07 ± 11.48 years, and 41.24 ± 14.82 years in group L, group P, and group T, respectively. No significant differences were found between the three groups concerning patient age, stone location, or session duration (P>0.05). The mean VAS scores and analgesic consumption were lower in group L compared with other groups (P<0.05). CONCLUSION The results of this study showed that additional administration of analgesics was decreased with intravenous lornoxicam in comparison with paracetamol and only tramadol.

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

Is there an alliance between body mass index and end-tidal carbon dioxide partial pressure?

Material and Methods: After obtaining written informed consents, the demographic data including age, gender, weight, height, body-mass index, and the American Society of Anesthesiologists score were recorded. In operating theatre, after 15 minutes of spontaneous ventilation in supine position wearing a modified face mask, the respiratory rate, and end-tidal carbon dioxide partial pressure measurements were obtained. The association between body-mass index, respiratory rate, and end-tidal carbon dioxide partial pressurewere analyzed using Pearson’s correlation (r).