This preliminary report the on effects of QUE in a chronic constriction injury model proved significant effects of the agent, which should be supplemented with different studies using different dose regimens.

AIM: Increased intracranial pressure following trauma and subsequent possible development of brain death are important factors for morbidity and mortality due to ischemic changes. We aimed to establish the role of ischemic modifi ed albumin (IMA) in the early diagnosis of the process, starting with increased intracranial pressure and ending with brain death. MATERIALS AND METHODS: Eighteen Wistar-Albino rats were divided into three groups; control (CG, n = 6), increased intracranial pressure (ICPG, n = 6), and brain death (BDG, n = 6). Intracranial pressure elevation and brain death were constituted with the infl ation of a balloon of a Fogarty catheter in the epidural space. In all three groups, blood samples were drawn before the procedure, and at minutes 150 and 240 for IMA and malondialdehyde (MDA) analysis. RESULTS: Serum IMA levels at 150 and 240 minutes were higher in ICPG than in CG (p < 0.05). IMA levels were similar in ICPG and BDG. Serum MDA levels at 150 and 240 minutes increased in ICPG and BDG groups compared to CG (p < 0.05). MDA levels were similar in ICP and BD groups. CONCLUSION: IMA should be considered as a biochemical parameter in the process starting from increased intracranial pressure elevation and ending at brain death (Tab. 3, Fig. 5, Ref. 31). Text in PDF www.elis.sk. KEY WORDS: ischemic modifi ed albumin, increased intracranial pressure, brain death.

We aimed to perform an epidural patch using platelet rich plasma (PRP), which has the potential to regenerate and heal tissues via degranulation of platelets, in a 34-year-old parturient suffering from persistent post-dural puncture headache (PDPH) after failed epidural blood patch (EBP). After her admission to our unit, we reconfirmed the clinical and radiologic diagnosis of PDPH. Cranial MRI with contrast showed diffuse pachymeningeal thickening and contrast enhancement with enlarged pituitary consistent with intracranial hypotension. Clinical and radiological improvements were observed 1 week after the epidural patch using autologous PRP. Therefore, we recommend using autologous PRP for epidural patching in patients with incomplete recovery after standard EBP as a novel successful approach.

Bu çalışmada deneysel bir iskemi-reperfüzyon yaralanması modelinde alfa-lipoik asit ile önkoşullamanın nöronal hasar üzerinde koruyucu etkisi olup olmadığı araştırıldı. Ça lış ma pla nı: On sekiz erişkin erkek Yeni Zelanda tavşanı (2.4-3.5 kg) eşit olarak sham, kontrol ve tedavi gruplarına ayrıldı. Kontrol ve tedavi gruplarında abdominal aort renal artere proksimal olarak 1 cm aşağıdan ve bifürkasyona distal olarak 1 cm yukarıdan anevrizma klipsleri kullanılarak 30 dakika tıkandı. Tedavi grubuna aortik kros-klemplemeden 20 dakika önce intraperitoneal 100 mg/kg lipoik asit uygulandı. Hayvanlar ameliyattan 48 saat sonra sakrifiye edildi ve L2 ve L5 arasındaki spinal kord segmentleri biyokimyasal ve histopatolojik analiz için çıkartıldı. Spinal kordda glutatyon, malondialdehit, total nitrat/nitrit, ileri oksidasyon protein ürünleri, katalaz, süperoksit dismutaz ve glutatyon peroksidaz seviyeleri incelendi. Bul gu lar: Alfa-lipoik asit ile önkoşullama oksidatif stresin ölçülen tüm parametrelerinde anlamlı olarak olumlu etkiler gösterdi. Dokuların histopatolojik değerlendirmesinde kontrol grubuna kıyasla tedavi grubunda anlamlı olarak azalmış nöronal dejenerasyon, aksonal hasar, mikroglial ve astrositik infiltrasyon görüldü. So nuç: Bu çalışmanın sonuçları aortik kros-klemplemeden önce alfalipoik asit uygulamasının tavşanlarda spinal kord yaralanmasında anlamlı nöro-koruyucu etkisi olduğuna işaret etmektedir.

Arthroscopic shoulder surgical procedures were performed under general anesthesia with the patient in the beach chair position. [1] However, the peripheral nerve block in arthroscopic shoulder surgery is advantageous in providing intra-and postoperative pain relief, as well as good recovery and rehabilitation. [1,2] Interscalene brachial plexus block which is performed by administering local anesthetics to the C5 and C6 nerve roots between the anterior and middle scalene muscles is among the regional techniques frequently used for anesthesia and/or analgesia for shoulder surgery. [2] During interscalene block (ISB) application, diaphragm Objectives: The aim of this study was to investigate the effects of traditional interscalene block (ISB) alone and ISB combined with superior truncus block (STB)-associated diaphragm paralysis evaluated by ultrasound, duration of analgesia, and rate of complication in patients undergoing arthroscopic shoulder surgery.Patients and methods: Between January 2020 and December 2022, a total of 285 patients (158 males, 127 females; mean age: 48.0±15.1 years; range, 18 to 80 years) who underwent arthroscopic shoulder surgery under ISB, either alone or combined with STB, were retrospectively analyzed. The patients were operated under ISB alone using 30 mL 0.5% bupivacaine (n=140) or ISB using 10 mL (n=67) or 5 mL 0.5% bupivacaine (n=78) combined with STB using 20 mL 0.5% bupivacaine. Ultrasound reports of all patients' diaphragm function were also retrieved. Duration of analgesia, need for additional analgesics, and the type of analgesic drugs, and evaluations of patient and surgeon satisfactions were evaluated. Degree of diaphragm paralysis considered as complete (≥75%), partial (25.1 to 74.9%) and no paralysis (≤25%) were evaluated for comparison between the block types. Results:The patients underwent operation due to rotator cuff rupture (n=218) or Bankart (n=67). Duration of analgesia, need for additional analgesia, and the type of analgesic drugs used were comparable between the block types. The most common complication was Horner syndrome (n=96, 33.68%) which was significantly lower in ISB (5 mL) +STB (20 mL) than the others (17.9% vs. 41.4% and 37.3%, p=0.002). The ISB (5 mL bupivacaine 0.5%) + STB (20 mL bupivacaine 0.5%) resulted in less complete diaphragm paralysis with adequate surgical anesthesia not requiring general anesthesia. Conclusion:The ISB using 5 mL of 0.5% bupivacaine + STB instead of traditional ISB alone can be preferred due to the low rate of complete hemi-diaphragm paralysis with adequate surgical anesthesia/analgesia and high patient and surgeon satisfaction.

No abstract

SPV grubunda her iki süre de anlamlı olarak daha kısaydı (p<0.001). Anestezi idamesi sırasında end-tidal sevofluran konsantrasyonları SPV grubunda anlamlı olarak daha düşüktü (p<0.05). Toplam remifentanil tüketimi de SPV grubunda anlamlı olarak azdı (p<0.001). Sonuç: Bir karar destek sistemi olarak SPV, spinal cerrahi sırasında anestetik madde titrasyonunu hassas bir şekilde sağlayarak intraoperatif karar vermeyi iyileştirdi, daha hızlı derlenme sağladı ve anestetik tüketimini azalttı.

Background/Aim: Pediatric neuroanesthesia is a special field that requires significant experience and infrastructure because of anatomical, neurological, and pharmacological differences in the pediatric patient population. Although technological improvements provide more effective and safer neuroanesthesiological management, the principles of neuroanesthesia, neurocognitive development, and the effects of anesthetic agents on central nervous system development are well-known. The majority of pediatric neuroanesthesia articles in the literature are reviews; however, retrospective/prospective case series and controlled research are limited. In this retrospective cohort study, we aimed to contribute to the existing literature by reviewing and analyzing our single-center 10-year experiences and results addressing pediatric neuroanesthesia management. Methods: After ethical committee approval, anesthetic and surgical reports from 1165 pediatric neurosurgical cases over ten years were collected. Demographic data, intra-operative vascular management, anesthesia techniques, airway management, patient positions, analgesia methods, and complications were evaluated in this retrospective cohort study. The available surgical intervention, patient positions, intra-operative neuromonitorization (IONM), and intra-operative magnetic resonance imaging (IOMR) records were also analyzed. Results: Six-hundred forty-six (55.4%) girls and 519 (44.5%) boys were included in the study. The median age was 60 (0–216) months. Cranial interventions were performed in 842 (72.3%) patients, and spinal interventions were performed in 323 (27.7%) patients. Patients’ American Society of Anesthesiologists (ASA) physical scales grouped as I, II, III, and IV were 718 (61.6%), 360 (30.9%), 82 (7%), and 5 (0.4%), respectively. Sevoflurane (40.3%), propofol (37.2%), and sodium thiopental (2.5%) were used for anesthetic induction. Neuromuscular block was performed with rocuronium (56.7%) and atracurium (14.4%). Neuromuscular blocking agents were not used in 337 patients (28.9%). A blood transfusion was required in 120 patients (10.3%), and 40% of these patients underwent surgery for craniosynostosis. Two-hundred twenty-two (19.1%) were monitored with IONM, and IOMR was carried out in 124 (10.6%) of the cases. The anesthesia-related complication rate was 5.15% (60 patients). Conclusion: Although pediatric neurosurgical interventions involve high risks, they are becoming increasingly common in our daily practice. Neuroanesthesiologists should know the procedures, techniques, and advances for safe and effective management of pediatric neurosurgical cases. We think that these data may be helpful as a guide for the anesthetic management of pediatric neurosurgical cases.