Combining subcostal TAP blocks with general anesthesia significantly reduced perioperative and postoperative opioid consumption, provided shorter anesthesia recovery time, and length of hospital stay in living liver donors.
Lorazepam is normally administered as a solution in organic solvents such as propylene glycol. This type of formulation is undesirable. This study describes the development of a parenteral emulsion formulation for lorazepam. The stability of lorazepam in the emulsion was examined. Ten per cent corn oil emulsions stabilized with egg lecithin, Pluronic F68 and Pluronic F88 were used. The incorporation of lorazepam does not appear to destabilize the emulsion, and lorazepam itself appears to be stable for at least 1 year in this liquid formulation. Haemolysis caused by emulsion formulations containing lorazepam and different emulsifiers was evaluated using human and rabbit blood to assess their safety as parenteral drug carriers. The results show that the emulsions did not have any significant haemolytic activity whereas organic solvents and solutions of lorazepam in organic solvents caused substantial haemolysis.
Key Clinical MessageManagement of airway in patients who have Coffin‐Siris syndrome (CSS) is often problematic because most of these patients have difficult airway. NTI via C‐MAC VL is an useful alternative to direct laryngoscope for orotracheal intubation in airway and anesthetic management in a case of CSS. Alternative airway devices should be readily available.
Treacher Collins Syndrome (TCS) is a dominantly inherited autosomal disease which limited to head and neck movement. In management of difficult airways which is seen in patients with TCS, the direct laryngoscope, video-laryngoscope (VL), and fiber-optic laryngoscope (FOB) were successfully utilized. No study that was indicated the successful execution of nasotracheal intubation on a patient with TCS by using C-MAC video-laryngoscope was found in literature review. In this case report, we aimed to share our airway management on a patient with TCS for whom we planned nasotracheal intubation due to a dental surgery.
In this study, we aimed to evaluate the mean changes in the corneal endothelial cells and pachymetry values of patients who underwent general anesthesia with sevoflurane with N2O or O2. Materials and Methods: Forty eyes of 40 patients who had extraocular surgery under general anesthesia were included in this prospective study. The patients were divided into two groups as the O2 and N2O groups, for which %50 O2 (total flow rate; 2 L/min in O2-air mixture) and %50 O2 (total flow rate; 2 L/min in O2-N2O mixture) were used, respectively. The duration of the surgery was recorded. The CD (cell density), CV (cell variation), Hex (hexagonality rate) and pachymetric specular microscopy results were evaluated before surgery, and at the first and fourth weeks after surgery. Results: The surgical duration and demographic data of the groups were similar, and there was no statistically significant difference between the two groups. The value of CV was 26±2 cell/mm2 for the O2 group and 30 cell/mm2 for the N2O group at the first week. There was a statistically significant increase in the N2O group values, compared to the preoperative values (p=0.008). The Hex value was 52±10% for the O2 group and 62±11% for the N2O group at the first postoperative week, and there was a statistically significant increase in the N2O group values in comparison to the preoperative values (p=0.007). There was no significant difference between the two groups in terms of CD, CV, Hex, and pachymetry at other times. Discussion and Conclusion: Statistically significant change was observed at the first postoperative week in the corneal variation and hexagonality rate values of the pediatric patients who underwent general anesthesia with nitrous oxide. More studies need to be done for further assessments.
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