Paracetamol, a centrally acting inhibitor of cyclooxygenase, has less gastrointestinal and platelet-inhibiting side effects and is clinically better tolerated than nonsteroidal anti-inflammatory drugs. Therefore, it will be ideally suited for postoperative pain relief. In this prospective, double-blind, randomized, placebo-controlled study, we evaluated the analgesic efficacy, opioid-sparing effect and effects on opioid-related adverse effects of intravenous (IV) paracetamol in combination with IV morphine after lumbar laminectomy and discectomy. Forty patients were divided into 2 groups (n=20 each) to receive either paracetamol 1 g (group 1) or 0.9% NaCl 100 ml (group 2) at the end of the operation and at 6-hour intervals over 24 hours. IV patient-controlled analgesia with morphine was used as a rescue analgesic in both groups. Pain was evaluated at rest and on movement at the 1st, 2nd, 4th, 6th, 12th, 18th, and 24th hours using a visual analog scale. Hemodynamic parameters, morphine usage, patient satisfaction, and probable side effects were also evaluated. Pain scores at rest and on movement at the 12th, 18th, and 24th hours were significantly lower in group 1 (P<0.001). Morphine consumption was not statistically significantly different between the groups (P>0.05). Vomiting in group 2 was significantly higher (P=0.027). Significantly more patients in the paracetamol group rated their pain management as excellent (45% vs. 5%). Although repeated IV paracetamol usage after lumbar laminectomy and discectomy did not demonstrate a significant opioid-sparing effect, it did decrease visual analog scale scores at certain evaluation times and incidence of vomiting and increase patient satisfaction.

Propofol with antioxidant activity may offer many advantages by scavenging reactive oxygen species and their metabolites in case of anticipated hypoperfusion-reperfusion phenomenon, such as would occur in laparoscopic surgery.

A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Diabetic peripheral neuropathic pain affects the functionality, mood, and sleep patterns of approximately 10 to 20 percent of patients with diabetes mellitus. Treatment goals include restoring function and improving pain control. In this study we aimed to compare the efficacy of transcutaneous electrical nerve stimulation (TENS) and placebo TENS in the treatment of peripheral neuropathic pain in patients with type II diabetes mellitus (DM). M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Forty patients who were diagnosed as type II DM with peripheral neuropathy were enrolled to this study. Patients were randomly divided into two groups as Group A (n= 20) TENS group and Group B (n= 20) placebo TENS group. Forty-eight hours before the beginning of TENS therapy, the drugs used for the treatment of neuropathic pain were discontinued. The electrodes of the TENS were bilaterally placed on the lumbosacral region, 3 cm lateral of the vertebral column. The frequency of the electrostimulation which was used in Group A patients was 80 hertz and the amplitude was high enough to create paresthesia. No electrostimulation was given to Group B patients. TENS was applied 30 minutes daily and the procedure was continued for 20 days in both groups. Visual analog scale (VAS) scores and pain grades of the patients at certain times were taken into account for evaluating the effectiveness of the procedure. R Re es su ul lt ts s: : The demographic data of the groups were not significantly different. Although VAS scores before procedure and on the 5 th day of the procedure were not significantly different between groups (p> 0.05), VAS scores on 10 th and 20 th days of the procedure in Group A were significantly lower than Group B (p< 0.001). There was no significant difference between pain grades of Group A and B at the beginning of the study, but pain grades in Group A were significantly lower than Group B when evaluated at the end of the study (p< 0.001). C Co on nc cl lu us si io on n: : Treatment of the patients with DN is a challenging for the physicians. TENS can be used as an efficient and safe treatment option especially in DN patients in whom pharmachologic treatment is contraindicated or inefficient. Placebo TENS has a limited placebo effect in diabetic neuropathy patients. Bu ul lg gu ul la ar r: : Gruplar arasında demografik veriler yönünden anlamlı farklılık yoktu. İşlem öncesi ve işlemin 5. gününde VAS skorları yönünden gruplar arasında farklılık olmamakla birlikte, Grup A'nın 10. ve 20. günlerdeki VAS skorları grup B'ninkilerden anlamlı olarak daha düşüktü. Çalışma başlangıcında gruplar arasında ağrı dereceleri yönünden fark olmamasına rağmen, çalışma sonunda Grup A'nın ağrı dereceleri Grup B'ninkilerden anlamlı derecede daha düşüktü. S So on nu uç ç: : Diabetik nöropatik ağrısı olan hastaların tedavisi ciddi bir problemdir. TENS özellikle farmakolojik tedavinin kontrendike veya yetersiz olduğu diabetik nöropati hastalarında etkin ve güvenilir bir tedavi...

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A 4-month-old boy with Proteus syndrome underwent a successful operation for a left abdominal mass due to hydroureter and hydronephrosis with left ureterovesical stenosis. The operation lasted 4.5 h under general anaesthesia; there were no anaesthetic complications. There is only one previous report on anaesthesia in a patient with Proteus syndrome.

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A 6-month-old boy with Sturge-Weber syndrome was scheduled for congenital glaucoma and left buphthalmus surgery. Physical examination revealed haemangioma throughout the right trigeminal nerve, congenital glaucoma, left megalocornea and bilateral buphthalmus. Examination of the eye was performed under general anaesthesia, was followed 2 days later by trabeculotomy. No premedication was given to the patient. After induction of anaesthesia with halothane, O2 and N2O muscle relaxation was achieved with atracurium and he was intubated gently. No difference was observed in vital signs during surgery. At the end of the operation he was given oxygen 100% and extubated, muscle relaxant reversal was with atropine and neostigmine. No complication was observed in the post-operative period.

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