Sedación y Analgesia en Colonoscopia Electiva: Propofol-fentanilo versus Propofol-Alfentanilo

ResumenJustificativa y objetivoLa sedación y la analgesia están recomendadas en la colonoscopia para propiciar la comodidad, porque son procedimientos invasivos y pueden ser dolorosos. Este estudio tuvo el objetivo de comparar las combinaciones de propofol-alfentanilo y propofol-fentanilo para la sedación y la analgesia en pacientes sometidos a la colonoscopia electiva.MétodosEstudio prospectivo y aleatorio. Participaron en el estudio 80 pacientes, ASA I-II, entre 18 y 65 años. La inducción de sedación y la analgesia fue hecha con propofol (1 mg.kg-1) y fentanilo (1 μg.kg-1) en el grupo propofol-fentanilo (PF) y con propofol (1 mg.kg-1) y alfentanilo (10 μg.kg-1) en el grupo propofol-alfentanilo (PA). Para el mantenimiento, dosis adicionales de propofol se administraron en bolos de 0,5 mg.kg-1 para obtener las puntuaciones de 3-4 en la Escala de Sedación de Ramsey (ESR). Se registraron los datos demográficos, la frecuencia cardíaca, la presión arterial promedio (PAP), la saturación de oxígeno de la hemoglobina (SpO2), los valores de la ESR, el tiempo de colonoscopia, la dosis total de propofol, las complicaciones, el tiempo de recuperación y el tiempo para el alta, como también las puntuaciones de satisfacción del colonoscopista y del paciente.ResultadosLa PAP a los 15 minutos en el Grupo PA fue significativamente mayor que en el Grupo PF (p = 0,037). La frecuencia cardíaca promedio del grupo PA fue mayor al inicio que en las mensuraciones posteriores (p = 0,012, p = 0,002). El promedio de la dosis total de propofol del Grupo PA fue significativamente mayor que la del Grupo PF (p = 0,028). El tiempo promedio de recuperación del grupo PA fue significativamente mayor que el del grupo PF (p = 0,032).ConclusionesEl Fentanilo proporciona mejores condiciones de operación y reduce la necesidad de dosis adicionales de propofol. Esas ventajas reducen el tiempo de recuperación. Por tanto, el propofol-fentanilo es superior al propofol-alfentanilo para la sedación y la analgesia en la colonoscopia

Sedation-Analgesia in Elective Colonoscopy: Propofol-Fentanyl Versus Propofol-Alfentanil

AbstractBackground and objectivesSedation-analgesia is recommended for comfortable colonoscopy procedures, which are invasive and can be painful. This study aimed to compare the combinations of propofol-alfentanil and propofol-fentanyl for sedation-analgesia in elective colonoscopy patients.MethodsThis prospective and randomized study was planned in ASA I-II groups and included 80 patients between the ages of 18 and 65 years. Sedation-analgesia induction was performed as 1μg.kg-1 fentanyl, 1mg.kg-1 propofol in the propofol-fentanyl group (Group PF) and 10μg.kg-1 alfentanil, 1mg.kg-1 propofol in the propofol-alfentanil group (Group PA). Patients’ scores were limited to 3-4 values on the Ramsey Sedation Scale (RSS) by 0.5mg.kg-1 bolus additional doses of propofol in sedation-analgesia maintenance. We recorded demographical data, heart rate, mean arterial pressure (MAP), oxygen saturation of hemoglobin (SpO2), RSS value, colonoscopy time, total dose of propofol, complications, recovery time, and discharge time, as well as colonoscopist and patient satisfaction scores.ResultsMAP at the 15th minute in Group PA was significantly higher than in Group PF (p = 0.037). Group PA's beginning mean heart rate was higher than the mean heart rate at subsequent readings (p = 0.012, p = 0.002). The mean total propofol dose of Group PA was significantly higher than the total dose of Group PF (p = 0.028). The mean recovery time of Group PA was significantly longer than that of Group PF (p = 0.032).ConclusionFentanyl provides better operative conditions and reduces the need for additional propofol doses. These advantages cause a shorter recovery time. Therefore, propofol-fentanyl is superior to the propofol-alfentanil for sedation-analgesia in colonoscopy

Oral Bacteria of Children with Turner Syndrome

Aim:Turner syndrome (TS) is a genetic disorder caused by a numerical or structural aberration of the X chromosome, which is associated with a female phenotype. Concerning oral status, several studies have revealed that girls with TS have dental anomalies and periodontal problems. The aim of this study was to evaluate the effects of oral bacteria on caries prevalence and periodontal status in pediatric patients with TS.Materials and Methods:Twenty TS patients and 17 healthy girls were examined for cariological and periodontal status. The levels of mutans streptococci (MS), lactobacilli (LB), yeast and 10 different periodontal bacteria were determined by using culture and microarray techniques in children’s stimulated saliva samples.Results:There was no difference in salivary flow rate and buffering capacity, decayed-missing-filled teeth, MS, LB, or yeast levels between the groups. Plaque index and gingival index levels were significantly higher in the Turner group and dft was significantly higher in the control group (p<0.05). As a result, microarray analysis, Prevotella intermedia, Fusobacterium nucleatum, Eikenella corrodens, Aggregatibacter actinomycetemcomitans, Actinomyces viscosus were detected at high levels in the Turner group (p<0.05).Conclusion:Besides dental and craniofacial anomalies, clinicians should be alert to the early diagnosis and treatment of periodontal problems in patients with TS

A study on the relationship between the social-emotional adaptation and behavioral problems of 60-72 month old preschoolers

AbstractThe aim of this rearch is to define the relation between social-emotional adaptation and behavior problems of 60-72 month old children. The data collection instruments ‘Preschool Behavior Problem's Scanning Scale’ and Marmara Social-Emotional Adaptation Scale for 60-72 Month Old Children’ were applied to 432 chldren who were attending public and private preschools in Istanbul. A statistically meaningful and negative relation was found between childen's total score of Preschool Behavior Problem's Scanning Scale and Marmara Social-Emotional Adaptation Scale for 60-72 Month Old Children. As a function of decrease of childen's social-emotional adaptation level, their behavior problems increase

A study on the relationship between the social-emotional adaptation and behavioral problems of 60-72 month old preschoolers

The aim of this rearch is to define the relation between social-emotional adaptation and behavior problems of 60-72 month old children. The data collection instruments 'Preschool Behaviour Problem's Scanning Scale' and 'Marmara Social-Emotional Adaptation Scale for 60-72 Month Old Children' were applied to 432 children who were attending public and private preschools in Istanbul. A statistically meaningful and negative relation was found between children's total score of Preschool Behaviour Problem's Scanning Scale and Marmara Social-Emotional Adaptation Scale for 60-72 Month Old Children. As a function of decrease of children's social-emotional adaptation level, their behavior problems increase