Bevacizumab (Bev) is a vascular endothelial growth factor-A monoclonal antibody that targets tumor angiogenesis. The transfusion rate of Bev is 90 min in the first dose, 60 min in the second and than from the third dose it is 30 min if no hypersensitivity reaction occurs in the first two doses. The purpose of this study determines whether these initial prolonged infusions are really necessary or not. Between 2007 and 2009, we were using the standard schedule for Bev infusions. In July 2009, we reviewed our medical reports, nursing orders and adverse drug reaction forms to identify the Bev used patients and possible hypersensitivity reactions (HSRs). Depending on that information between August 2009 and July 2014, we started to make Bev infusions in 30 min from the first dose of the therapy. In this study, we documented the findings of these 30-min infusion used patients. From August 2009 to July 2014, we treated 145 patients with 1,145 Bev infusions each one in 30 min. Out of 145 patients, 12 of them received only single dosage of Bev infusion treatment. Bev doses were 5 mg/kg for 87 patients, 7.5 mg/kg for 64 patients, 10 mg/kg for four patients and 15 mg/kg for only one patient. No HSRs were reported during these transfusions. Initial prolonged infusion times are unnecessary for Bev. Thirty-minute infusion rates can be used safely for all courses.

Introduction: General anesthesia-related side effects are more common in the presence of chronic obstructive pulmonary disease (COPD). Regional anesthesia techniques should be considered in these patients to reduce the risks. In this study, we aimed to retrospectively review our experience of laparoscopic cholecystectomy with thoracic epidural anesthesia, which we carried out in the COPD group. Materials and Methods: A total of 34 patients who underwent laparoscopic cholecystectomy operation under thoracic epidural anesthesia in our general surgery clinic between 2014 and 2018 were enrolled in this study. All patients had COPD with American Society of Anesthesiologist (ASA) III-IV. Results: All patients were successfully operated with low CO 2 pneumoperitoneum (10 mmHg) under thoracic epidural anesthesia. Of all patients, 21 (61.8%) of them were male, and 13 (38.2%) of them were female with a mean age of 64 years (range: 52-76). Thirty-one (91.2%) of the patients had ASA III and 3 (8.8%) of them had ASA IV status. Analgesic was needed in 13 (38.2%) patients at the 6 th hour and three (8.8%) patients at the 12 th hour, while no analgesic was needed in any patients at the 24 th hour. The most common complaint in the perioperative period was right shoulder pain by 35.2% (n=12). In addition, nausea occurred in 29.4% (n=10) of the patients; abdominal discomfort, or pain was noted in nine (26.5%) patients. In the per-op period, three (8.8%) patients developed hypotension and two patients (5.9%) bradycardia. In the post-op period, any complain was not observed in 14 (41.2%) patients, while 11 (32.5%) patients had nausea/vomiting, shoulder pain in four (11.8%), and abdominal discomfort was seen in four (11.8%). When pre-and post-op respiratory function tests were compared, no adverse effect was seen due to thoracic epidural anesthesia. Conclusion: COPD patients who are at a high risk of general anesthesia can be operated under regional anesthesia without experiencing respiratory system complications and with less post-op pain.