Stellate ganglion blockage (SGB) is a method used for treating Raynaud’s phenomenon (RP). This study primarily aimed to determine whether the perfusion index (PI) can be used an alternative to Horner’s signs in evaluating the efficacy of SGB in patients diagnosed with RP. In a total of 40 patients, aged 18–65 years and diagnosed with primary RP, SGB was applied for 5 days on the same side with the 2-finger method, using 6 mL of 5% levobupivacaine at the 7th cervical vertebra level. The PI values were recorded from the distal end of the 2nd finger of the upper extremity on the side applied with the block at baseline and at 5, 15, 30, 60 and 120 min. The onset time of Horner findings was recorded. The PI values and visual analogue scale (VAS) pain scores were recorded pre-treatment and after 2 weeks.When the PI values of the 40 patients were examined, a 62.7% increase was observed from baseline to the first session at 5 min (p < 0.05). When all sessions were evaluated, a statistically significant increase was determined in the PI values measured at 5, 15, 30, 60 and 120 min compared with the baseline PI values. There was a statistically significant decrease in the post-treatment VAS pain scores and a statistically significant increase in the post-treatment PI values (p < 0.05). By eliminating peripheral vasospasm with the application of SGB in patients with RP, the distal artery blood flow and PI are increased. PI measurement is a more objective method and therefore could be used as an alternative to Horner findings in evaluating the success of SGB. PI is a non-invasive and simple measurement and also an earlier indicator in evaluating the success of SGB than Horner’s signs.
Aim: To investigate the efficacy of lornoxicam in the prevention of the pain associated with propofol injection.
Material and method: Approval for this study was granted by the ethics committee of our hospital. Using a computer randomisation software, 120 patients undergoing elective surgery were assigned to four equal groups. In Group I (control group), immediately before anaesthesia induction, 10 ml of isotonic 0.9% NaCl solution (placebo) was administered intravenously (IV). In Groups II, III and IV, the same injection contained 2 mg, 4 mg and 8 mg of lornoxicam respectively. A tourniquet was then applied to the forearm for two minutes. Pain evaluation was made using a verbal pain score.
Results: Differences in pain severity scores were statistically significant between Groups I and II, Groups I and III, Groups I and IV and between Groups II and III (p < 0.05). However, no significant difference was determined between Groups III and IV (p = 0.401).
Conclusion: In all groups administered with lornoxicam, there was a significant reduction in the severity of pain associated with propofol injection, in comparison with the control group. Maximum effect is obtained with a dose of 4 mg.
OBJECTIVE:The present study is an analysis of cancer patients who received follow-up treatment for either cancer-related complications or treatment-associated side effects while hospitalized in the intensive care unit (ICU).METHODS:Records of cancer patients treated at Dr. Lütfi Kırdar Kartal Training and Research Hospital ICU between January 1, 2011 and December 31, 2012 were retrospectively reviewed. Demographic data and type of cancer were recorded in prepared forms and subsequently analyzed.RESULTS:Among 2240 ICU patients treated and hospitalized between January 1, 2011 and December 31, 2012, 482 cancer patients were identified and included in the study. Percentage of cancer patients in ICU was 23.9%. Male to female ratio was determined to be 1.55. First 3 most common cancers found were colorectal (19.7%), lung (15.7%), and stomach cancers (11.6%). Mortality rate of cancer patients hospitalized in ICU was 46.6%. Larynx, lung, urinary bladder, skin, rectosigmoid, hematological, and kidney cancer were more prevalent in male patients, whereas esophageal cancer was seen in more female patients than male patients. Incidence of stomach, brain, and pancreatic cancers, as well as unclassified tumors, was found to be unrelated to gender.CONCLUSION:Rectosigmoid cancer was most common type of cancer observed in our ICU. Esophageal cancer was observed in more females than males, while larynx cancer was more frequently present in males.
Objective: The aim of the present study was to compare the effects of two inhalation anesthetics, desflurane and sevoflurane, on middle ear pressure. Methods: After we obtained written consent from the patients and the approval from our institutional ethical committee, we included 56 ASA I-II patients aged between 18 and 60 years in this study. They were randomly divided into two groups of 28 patients each. Desflurane 4-6% (Group D) or sevoflurane 1-2% (Group S) were used for anesthesia management in patients. Baseline tympanometry was carried out and recorded before the induction of anesthesia on both ears, and 3 more measurements were done and recorded 5, 15 and 30 min after induction. Results: In both groups, middle ear pressure values were found to be significantly elevated when compared to baseline measurements (p < 0.05). When middle ear pressure was compared between the groups, no difference was found between the values obtained at baseline and at 5 min in Group S, while especially the values obtained at 15 min revealed significantly higher middle ear pressures in Group D. Conclusion: It was observed that the increase in middle ear pressure caused by sevoflurane was significantly lower than that caused by desflurane.
Çalışmamızda spinal anestezi altında ultrason eşliğinde uygulanan transvers abdominis plain (TAP) bloğun; sezaryen operasyonlarında postoperatif analjezi ve opioid tüketimine etkisini retrospektif olarak incelemeyi amaçladık. Gereç ve Yöntem: 2016 Mayıs-Ekim ayları arasında elektif şartlarda spinal anestezi altında sezaryen operasyonu olan ve çalışmaya dahil edilen 58 hastanın dosyaları retrospektif olarak incelendi. Hastalar TAP blok uygulananlar (Grup 2) ve uygulanmayanlar (Grup 1) olarak iki gruba ayrıldı. Demografik veriler, postoperatif 1, 2, 4, 6, 9, 12 ve 24. saatte bakılan vizüel analog skala (VAS) değerleri, non steroid anti-inflamatuvar ilaç ve opioid tüketimleri değerlendirildi. Ayrıca ilk analjezik ve opioid ajan yapılma zamanları da kaydedildi. Bulgular: Grup 1 hastaların (n=27) postoperatif 1. ve 4. saat VAS değerleri Grup 2'ye (n=31) göre anlamlı derecede yüksek bulundu. Grup 1'de 18 hastada (%66,6), grup 2'de 9 hastada (%29) opioid kullanıldı. İlk opioid uygulama zamanı grup 1 de ortalama 200,27 dakika, Grup 2'de ise 263.33 dakika olarak bulundu (p<0,05). Sonuç: Sezaryen gibi alt abdominal cerrahi operasyonları sonrası ağrı kontrolünde TAP blok uygulanmasının opioid tüketimini azalttığını düşünmekteyiz.
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