Objective: Recovery from neuromuscular blockade could be delayed and the risk of postoperative residual neuromuscular blockade (RNMB) could be an important anesthetic consideration in diabetic patients undergoing general anesthesia due to decreased nerve conduction velocity. The aim of this study was to analyse the recovery from rocuronium and the risk of postoperative RNMB in type-II diabetic patients undergoing general anesthesia with sevoflurane. Materials and Methods: The patients undergoing general anesthesia with sevoflurane and rocuronium for abdominal surgery were included in this prospective observational study between December 2014 - May 2015. After rocuronium injection; time to reappearance of T1, T2, T3 and T4 and time to reaching TOF ratios of 0.7 and 0.9 were recorded. For detecting RNMB, TOF ratios were recorded in the postoperative care unit at 5th and 10th minutes of arrival. The correlation between glycemic control and the risk of RNMB was also evaluated via glycosylated haemoglobin (HbA1c) levels. Results: A total of 82 patients (Group DM: 48 patients, Group non-DM: 34 patients) were included. The groups were comparable according to demographic data and other characteristics that can effect neuromuscular blockade. Times to reappearance of T1, T2, T3, T4 and to reaching a TOF ratio of 0.9 were significantly longer in Group DM. Although there was no difference between the TOF ratios at the arrival to the postoperative care unit, TOF ratios of Group DM were significantly lower at 5th and 10th minutes at postoperative care unit. Poor glycaemic control was found not to affect the risk of RNMB. Conclusion: Even in the absence of known neurologic complications; the neuromuscular blockade effect of rocuronium is longer and the risk of RNMB is higher in type-II diabetic patients irrespective of the degree of glycaemic control. Keywords: Diabetes Mellitus, Rocuronium, Residual Neuromuscular Blockade
ÖZ: Kapsüller, genellikle primer patlayıcı içerikli, mühimmat sisteminin ateşleme serisinin ilk elemanlarıdır. Farklı tip ve tasarımda olmalarına rağmen fonksiyonel olarak "elektrikli" ve "darbeli" olarak iki grupta sınıflandırılabilir (Yıldırım, 2013). Elektrikli kapsüller, silah sistemi tarafından uygulanan elektrik akımı ile aktive olurlar ve bu akıma karşı hassas bir primer patlayıcı ve akımı patlayıcıya iletebilecek, patlayıcı ile temas halinde bulunan bir iletken telden oluşurlar (Matyas ve Pachman, 2013). Bu çalışmada tank mühimmatı kapsüllerinin tasarımı sırasında kullanılan direnç tellerinin kapsüllerin aktivasyon zamanı üzerindeki etkileri irdelenmiştir. Kapsüller farklı biçimlerde tasarlanmış ve bu tasarımların zaman üzerindeki etkilerini belirlemek için fonksiyon testine tabi tutulmuşlardır.
Creating and developing purchase intention in social media is an important strategic goal for businesses. Marketers, in particular, feel the need to invest in consumer-brand engagement (CBE) in social media marketing more than ever before as social media platforms are available for consumers to socialize and interact with each other. However, current research in marketing provides little guidance to marketers how brand pages in Facebook can be leveraged to engage customers and create purchase intention for the brands. Toward filling this gap, the present research examines the customer's brand engagement-purchase intention link with the mediating role of customer's information motivation in social media. Using data from 298 surveys of brand pages are analysed in partial-least squares (PLS) structural equation modelling (SEM). The research fills a gap in the literature through its analysis of the mediating role of information motivation of consumers in the relationship between customer-brand engagement and purchase intention in social media. The specific strategies, and the implications of this research for theory and practise are discussed.
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