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.

IntroductionRobot-assisted laparoscopic surgery has developed greatly and is becoming a standard technique for radical prostatectomy. It is widely preferred for pelvic surgeries because of its important advantages that minimize postoperative morbidity and mortality. Robotic surgeries in the pelvic region, including radical prostatectomy, rectum resection, and gynecologic procedures, usually require a steep Trendelenburg position and carbon dioxide pneumoperitoneum to secure the surgical field. Pneumoperitoneum combined with steep Trendelenburg position may cause significant changes in cardiovascular, respiratory, and neurophysiological parameters (1,2). Both the increase in abdominal pressure as a result of carbon dioxide insufflation and the head-down position have been shown to impair respiratory functions during the procedure by pushing the diaphragm upward and reducing lung volume and respiratory compliance, thus inducing atelectasis formation (3,4).Background/aim: This study was undertaken to evaluate the effects of positive end-expiratory pressure (PEEP) levels on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) and to determine the appropriate PEEP level during steep Trendelenburg position combined with pneumoperitoneum. Materials and methods:Ten pigs were included in this study. Pneumoperitoneum and Trendelenburg position were maintained and PEEP titration was initiated. Arterial pressure, heart rate, arterial blood gas, ICP, and CPP were recorded at the following time points: baseline (T0), 30 min after positioning and pneumoperitoneum (T1), PEEP 5 (T2), PEEP 10 (T3), PEEP 15 (T4), and PEEP 20 (T5).Results: MAP significantly increased at T1 compared to T0 and decreased at T4 and T5 compared to T1. ICP was 9.5 mmHg and CPP was 69.3 mmHg at T0. CO 2 insufflation and steep Trendelenburg position did not cause any significant difference in ICP and CPP. ICP increased and CPP decreased significantly at T4 and T5 compared to both T0 and T1. PaO 2 and PaO 2 /FiO 2 decreased significantly at T1 and T2 compared to T0, while both increased significantly at T3, T4, and T5 compared to T1. Conclusion:PEEP of 10 cmH 2 O was effective for providing oxygenation while preserving hemodynamic stability, ICP, and CPP in this model.