Effects of memantine on recovery, cognitive functions and pain after propofol anesthesia in rats

Postoperatif kognitif disfonksiyon anestezi sonrasında sıklıkla görülen bir durumdur. Anestezik ajanlardan propofol, postoperatif kognitif disfonksiyon yaptığı kanıtlanmış bir ajandır. Memantinin ise hafıza ve öğrenmeye olumlu katkıları olmasının yanında; nöroprotektif olduğu bilinen ve kronik ağrı tedavisinde kullanılan bir ajandır. Bu çalışmada memantinin, propofol anestezisi sonrasında derlenme, kognitif disfonksiyon ve ağrı düzeyine etkilerinin araştırılması amaçlandı. 24 adet Wistar cinsi ratlar rastgele 4 gruba ayrıldı. İlk gruba % 0,9 NaCl 1mL (Grup K) , ikinci gruba memantin 1mg/kg 1 mL SF içinde (Grup-M), üçüncü gruba 150 mg/kg propofol (Grup-P), dördüncü gruba 1mg/kg memantin 1mL SF ve propofol 150mg/kg (Grup-MP) uygulandı. Ratların derlenmesi `tail pinch', kognitif fonksiyonları `radial arm maze' ve ağrı düzeyleri `hot-plate' ile değerlendirildi. Ratlarda derlenme Grup-MP'de Grup-P'ye göre anlamlı süresi kısa idi ( p< 0,05). Radial arm maze üzerinde Grup-MP' de Grup-P'ye göre kollara giriş-çıkış sayısı 1. Saatte anlamlı yüksek idi (p<0,05). Hot-plate değerleri ise Grup-K hariç bütün gruplarda, grup içi karşılaştırıldığında, kontrol değerlerine göre anlamlı olarak yüksek bulundu (p<0,05). Sonuçta ise memantin propofol anestezisi sonrası derlenme, kognitif fonksiyonlar ve ağrı düzeyine olumlu etkileri olduğu kanaatindeyiz.Postoperative cognitive dysfunction is a frequent complication after anesthesia. On the contrary propofol is an anesthetic agent that has been proved to cause cognitive dysfunction. Memantine has benefical effects on memory deficits and learning process. It has also neuroprotective effects and is used for treatment of choronic pain syndromes. This study was designed to determine the effects of memantine on recovery, cognitve functions and pain after propofol anesthesia. Twenty Four Wistar rats were divided into 4 groups randomly: Group K (n=6) % 0,9 NaCl 1mL, Group M (n=6) memantine 1mg/kg in 1mL SF, Group P (n=6) 150 mg/kg propofol, Group MP (n=6) 1mg/kg memantine in 1mL SF, after 30 minutes 150 mg/kg propofol. Recovery, cognitive functions and pain were eveluated by tail pinch teste, RAM and hot-plate respectively. In this study recovery durations of the rats in Group MP was shorter than rats in Group P (p< 0,05). Cognitive functions of rats in Group MP was higher than Group P at the first hour after recovery (p<0,05 ). Hot-plate response time at all time points were significantly longer when compared at basal values in all groups Group K. In this study we thought that memantine has beneficial effects on recovery, cognitive functions and pain after propofol anesthesia

Where are We on Organ Donation?

Objective: It was aimed to present the acceptance rate of organ donation of cases that were diagnosed with brain death and evaluated in terms of their demographic and clinical properties retrospectively in Adıyaman University Training and Research Hospital. Material and Method: In the intensive care unit of our hospital, cases that were diagnosed with brain death between the dates of January 2008 and December 2014 were retrospectively analyzed. Cases were evaluated in terms of age, sex, cause of brain death, blood groups, donation status, reasons for acceptance or rejection of donation, cardiac arrest, vasopressin treatment, laboratory test results, arterial blood gas values before and after the apnea test, intensive care unit follow-up durations, apnea test, seasonal and annual distribution. Also, potential donors and recipients were analyzed in accordance with their demographic characteristics. Results: The diagnosis of brain death was made in totally 57 cases; of those, 34 (59.6%) were men and 23 (40.4%) were women. The most common causes for brain death were traumatic subarachnoid hemorrhage (SAH) and intracerebral hematoma. Most of the cases had A Rh+ blood type (n=18, 31.5%) and the rate of brain death was 4.7 times higher in Rh (+) patients in comparison to Rh (-) patients. The rate of incidence of cardiac arrest was 12.3% (n=7), and it was more common in traumatic SAH patients. The rate of receiving vasopressor therapy was 21.1% (n=12), and the mean duration of therapy was 1.3±0.8 days. It was more commonly used in traumatic SAH patients (n=10). The follow-up period was 2.7±3.2 (minimum: 1, maximum: 17) days. Five patients were considered to be organ donors. The most common reason for acceptance of donation was the effect of organ transplantation coordinator during family interviews (n=3, 60%). In total, 4 livers, 5 kidneys and 1 heart transplantation operations were performed to 10 patients. Conclusion: Due to problems in organ donation, patients that might be potential organ donors must be transferred to intensive care unit and taken under critical patient care since then, and brain death should be considered in patients with Glasgow coma scale <7. The raising the awareness and training of the staff in intensive care units about the recognition of brain death and donor care are also important. Also, the interview with the families must be performed by an experienced coordinator to increase the rate of acceptance of donation and raise the awareness of the community regarding the organ donation

Pseudocholinesterase Enzyme Deficiency in Adıyaman City Area.

Pseudocholinesterase (PChE) is an enzyme responsible for the hydrolysis of succinylcholine. In case of its deficiency, the effect of succinylcholine that is approximately 5-10 min is prolonged up to few hours. The use of succinylcholine has been declined recently. However, it is still actively used in some special conditions and in developing countries. In this study, incidence of PChE enzyme deficiency around Adiyaman city was investigated and presented with the literature review