PURPOSE:To compared the effects of sevoflurane and desflurane on early anesthesia recovery in patients undergoing to craniotomy for intracranial lesions. METHODS:After IRB approval, the study included 50 patients aged 18-70 years who had ASA physical statuses of I-II and were scheduled for intracranial surgery. Patients were randomly divided into two groups: sevoflurane and desflurane. Anaesthesia was routinely induced in all patients followed by desflurane 5%-6% or sevoflurane 1%-2%. Moreover remifentanil infusion (0.05-0.2 mcg/ kg/min) was adjusted to maintain mean arterial pressure (MAP) within 20% baseline and heart rate <90 bpm. Postoperatively, patients were evaluated over time for responses to painful stimulus, eye opening, hand squeezing, extubation, orientation and time required to achieve a Modified Aldrete Score of 9-10. Parametric and non-parametric data were assessed using Student's t-and Mann-Whitney U tests, respectively. A p<0.05 was taken as statistically significant. RESULTS:The times to responses to painful stimuli (7.7±2.7 vs. 4.8±1.7 min.; p<0.001), emergence (9.5±2.81 vs. 6.3±2.2 min.; Early postoperative recovery after intracranial surgical procedures. Comparison of the effects of sevoflurane and desflurane

Background:Vitamin D is associated with musculoskeletal function in our body, and its deficiency is a common health problem all over the world. Low back pain (LBP) is an important health problem in terms of low quality of life, loss of work power, and cost of diagnosis and treatment approaches.Aims:The purpose of this study is to investigate the relationship between pain severity and Vitamin D deficiency in patients who applied to pain polyclinic with LBP.Settings and Design:This was a retrospective, observational study.Subjects and Methods:The files of patients aged between 18 and 70 years who applied to our hospital between January and February 2018 were examined retrospectively by a specialist. Serum 25-hydroxyvitamin D (25(OH)D) level, Visual Analogue Scale (VAS), age, education level, marital status, working status, and body mass index (BMI) values recorded in patient files were included in the study. The limit value of Vitamin D was accepted as 20 ng/mL. Patients were divided into two groups according to their levels of Vitamin D. Patients with serum 25(OH)D levels below 20 ng/mL were considered as the deficiency of Vitamin D (Group 1) and patients with 20 ng/mL and over 20 ng/mL values were considered as normal in terms of Vitamin D (Group 2).Statistical Analysis Used:Descriptive statistical data were presented as mean, standard deviation, numbers, and percentage. There was no difference between the normally distributed group and the non-normally distributed group in terms of vitamin D levels. To compare the frequencies, the Chi-square test was used. To define the linear association between independent variables and Vitamin D level, Spearman's rho correlation coefficients were calculated.Results:The level of Vitamin D was measured in 98 patients aged 18–70 years who applied to our hospital's polyclinic due to LBP during the study period. The deficiency of vitamin was detected in 84 (85.7%) of the patients, while Vitamin D was found in 14 (14.3%) as normal. Groups were similar in terms of age, gender, BMI, educational level, marital status and working status (p> 0.05); however, there was a statistically significant difference between the two groups in terms of VAS score and levels of Vitamin D (P < 0.001 and P < 0.001, respectively). While there was a negative correlation between D vitamin level and VAS score (r = −0.594, P < 0.001), there was no correlation between age, gender, BMI, education level, marital status, and working status (P > 0.05).Conclusions:The deficiency of Vitamin D is often asymptomatic, and also, it can cause bone and muscle pain. In our study, we determined that the severity of pain increased in patients with LBP as the deficiency of Vitamin D increased. For this reason, we recommend to be evaluated the level of Vitamin D in patients with LBP.

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.

BackgroundPulmonary aspiration of the gastric contents is a serious perioperative complication. The aim of this study was to evaluate the efficacy of portable ultrasonography in the preoperative evaluation of the gastric contents of patients. The secondary aim was to examine the relationship between gastric antrum cross-sectional area and age and body mass index (BMI).Material/MethodsThis single-center, prospective, cross-sectional study included 120 patients who underwent surgery. Measurements the gastric antral cross-sectional areas and quantitative and qualitative measurements of the stomach were taken by ultrasonography guidance in all patients.ResultsWith the patient in a supine position, the mean gastric antrum cross-sectional area was found to be 3.4±2.43 cm2 (range, 0.79–17.3 cm2). As the number of hours of fasting increased, the gastric antral cross-sectional area statistically significantly decreased (P<0.05). Increased age and BMI values were determined to increase the gastric antrum cross-sectional area in a linear correlation; r=0.209, P<0.05 and r=0.252, P=0.05, respectively. It was determined that 20.8% of the patients exceeded the high-risk stomach antral cutoff cross-sectional area that was defined as 340 mm2 in patients fasting for at least 8 hours.ConclusionsIt was determined that bedside ultrasonography is a useful, non-invasive tool in the determination of gastric content and volume. A significant proportion of surgical patients may not present with an empty stomach despite the recommended fasting protocols.

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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.

We demonstrate that the postoperative administration of FCBT or FCBZT is effective in lowering IOP after phacoemulsification cataract surgery; FCBZT more effectively lowered IOP than FCBT at postoperative days 3 and 5.

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