Objective: Evaluation of the effectiveness of ultrasound (US)-guided erector spinae plane block (ESPB) and thoracic paravertebral block (TPVB) compared to no intervention control group for postoperative pain management in video assisted thoracic surgery (VATS) patients. Method: Three groups -Group ESPB, Group TPVB and the control group (n=30 per group) were included in this prospective, randomized, controlled study. The US-guided blocks were performed preoperatively in the ESPB and TPVB groups. Intravenous patient-controlled postoperative analgesia via fentanyl was administered in all of the patients. The patients were evaluated using visual analogue scale (VAS) scores, opioid consumption, and adverse events. Results: At all time intervals fentanyl consumption and VAS scores were significantly lower both in ESPB and TPVB groups compared to the control group (p<0.001). Block procedure time was significantly lower and success of one time puncture was higher in Group ESPB as compared with that in Group TPVB (p<0.001). Conclusion: ESPB and TPVB provide more effective analgesia compared to control group in patients who underwent video-assisted thoracic surgery. ESPB had a shorter procedural time and higher success of single-shot technique compared to TPVB.
We concluded that PEEP with 5 or 8 cmHO has negative effects on lung function tests measured with spirometer during postoperative 1, 6, and 24 hours in patients underwent elective laparoscopic cholecystectomy.
Epidural anesthesia can provide anesthesia and analgesia for unilateral or bilateral lower extremity surgery and is associated with a low complication rate. We present our epidural anaesthetic management of a patient with both Amyotrophic lateral sclerosis (ALS) and Wolff-Parkinson-White (WPW) syndrome after intertrochanteric femur fracture surgery. It should be kept in mind that the choice of correct anaesthetic method in such patients with complicated neurological, pulmonary, and cardiac symptoms will significantly reduce postoperative mortality and morbidity.
ÖZ Beyin ölümü tüm beyin fonksiyonlarının geri dönüşümsüz kaybı ile karakterize intrakraniyal dolaşımın durduğu klinik bir durum olarak tanımlanmaktadır. Beyin ölümünün klinik teşhisinde, beyin sapı reflekslerinin yokluğu ve ağrılı uyaranlara motor yanıt yokluğunun tamamlayıcısı olarak kullanılan testlerden birisi apne testidir. Apne testi komplikasyon oranı yüksek olan bir testtir. Apne testi esnasında hipoksi, hipotansiyon, asidoz, kardiyak aritmi, asistol, pnömotoraks, pnömomediastinum ve pnömoperitonium gibi komplikasyonlar gelişebilir. Bu olgu sunumunda oksijen kanülünün havayolunu tıkaması sonucu gelişen hava hapsine bağlı bilateral pnömotaraks olgusu sunulmuştur. Anahtar Kelimeler: Apne testi, pnömotoraks, komplikasyon, barotravma ABSTRACT Brain death is characterized by irreversible loss of all brain functions and it is defined as a clinical condition where intracranial circulation stops. Apnea test is one of the tests which is used in the clinical diagnosis of brain death, absence of brain stem reflexes, and as a complement to absence of motor response to painful stimulants. Apnea test is a test which has a high complication rate. Complications such as hypoxia, hypotension, acidosis, cardiac arrhythmia, asystole, pneumothorax, pneumomediastinum and pneumoperitoneum may develop during an apnea test. In this case report, a patient with biletarel pneumothorax due to air trapping because of an oxygen cannula blocking the airway.
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