Clinical Study Spinal Anaesthesia with Hyperbaric Prilocaine in Day-Case Perianal Surgery: Randomised Controlled Trial

Background. The local anaesthetics used in day-case spinal anaesthesia should provide short recovery times. We aimed to compare hyperbaric prilocaine and bupivacaine in terms of sensory block resolution and time to home readiness in day-case spinal anaesthesia. Methods. Fifty patients undergoing perianal surgery were randomized into two groups. The bupivacaine-fentanyl group (Group B) received 7.5 mg, 0.5% hyperbaric bupivacaine + 20 g fentanyl in total 1.9 mL. The prilocaine-fentanyl group (Group P) received 30 mg, 0.5% hyperbaric prilocaine + 20 g fentanyl in the same volume. Results. Time to L1 block and maximum block was shorter in Group P than in Group B (Group P 4.6 ± 1.3 min versus Group B 5.9 ± 01.9 min, = 0.017, and Group P 13.2 ± 7.5 min versus Group B 15.3 ± 6.6 min, = 0.04). The time to L1 regression and S3 regression of the sensorial block was significantly shorter in Group P than in Group B (45.7 ± 21.9 min versus 59.7 ± 20.9 min, = 0.024, and 133.8 ± 41.4 min versus 200.4 ± 64.8 min, < 0.001). The mean time to home readiness was shorter for Group P than for Group B (155 ± 100.2 min versus 207.2 ± 62.7 min ( < 0.001)). Conclusion. Day-case spinal anaesthesia with hyperbaric prilocaine + fentanyl is superior to hyperbaric bupivacaine in terms of earlier sensory block resolution and home readiness and the surgical conditions are comparable for perianal surgery

IDENTIFICATION AND CHRACTERIZATION OF PLANT PATHOGEN EFFECTOR PROTEINS

IDENTIFICATION AND CHRACTERIZATION OF PLANT PATHOGEN EFFECTOR PROTEIN

Erratum of "Addition of lidocaine to levobupivacaine reduces intrathecal block duration: randomized controlled trial"

AbstractBackgroundThe duration of the spinal block is a concern for anesthetists. Low dose intrathecal lidocaine has vasodilatory effects and increases the local anesthetic clearance from the intrathecal space. The aim was to investigate whether this effect of lidocaine can be used to increase the resolution of levobupivacaine spinal anesthesia.MethodAfter obtaining ethical approval and informed patient consent, 40 patients underwent transurethral prostate resection were studied. Patients were randomized into two groups and patients received either levobupivacaine 6.75mg+0.3mL 2% lidocaine (Group L) or levobupivacaine 6.75mg+saline (Group C). The main outcome measures were the difference between groups regarding the duration of the spinal block and PACU stay. Secondary outcome measures were the difference between groups in onset and resolution of the spinal block, adverse events and treatments were also investigated.ResultsSpinal block resolved faster in Group L than Group C; 162.43±39.4min vs 219.73±37.3min (p=0.000). PACU time was shorter in Group L (109±49.9min in Group L vs 148±56.8min in Group C) (p=0.036). There was no difference between groups with respect to the incidence of adverse events and treatments. Groups were also similar regarding complications. PDPH and TNS were not observed in any group.ConclusionAddition of low dose lidocaine to hyperbaric levobupivacaine reduces the duration of the intrathecal block provided by hyperbaric levobupivacaine. This technique can be used to reduce the spinal block duration for relatively short procedures like TUR-P

Sensör Uygulamaları İçin THz Metamalzeme Yapıların Geliştirilmesi

Terahertz teknolojisinde metamalzemeler, doğal malzemelerden elde edilemeyen elektromanyetik özellikler gösterdiği ve istenen fonksiyonellikte tasarlanabildiğinden, yapay optik elemanların tasarımında önemli bir yere sahiptir. Son yıllarda elektromanyetik spektrumunun farklı frekanslarında çeşitli uygulamalar için metamalzeme alanında çok fazla araştırma yapılmış ve bu çalışmalar büyük ilgi görmüştür. Metamalzemeler geometrik olarak ölçeklendirilebilirler ve böylece radyo, mikrodalga, milimetre-dalga, uzak infrared (IR), orta-IR, yakın IR frekanslarını ve hatta görünür dalga boylarını kapsayan geniş bir frekans aralığında çalışabilirler. Analitik, nümerik ve deneysel yaklaşımlarla, özgün metamalzeme etkilerini araştıran birçok bilimsel çalışma başlamıştır. Metamalzemelerin farklı terahertz frekanslarında gösterdikleri rezonant etkiler özellikle detektör ve spektroskopik yöntemler açısından son derece önemli bir yer edinmeye başlamıştır. Bununla beraber ODTU KKK Elektrik ve Elektronik Mühendisliği Bölümünde öğreim üyesi olan Doç. Dr. Cumali Sabah ile birlikte geliştirdiğimiz metamalzeme çalışmaları terahertz dalga boylarında yeni bir teknoloji geliştirme alanı yaratmıştır. Kendisi THz metamalzeme yapıların tasarlanması ve modellenmesi konularında yetkindir, bizim grup ise daha çok bu malzemelerin karakterizasyonu ve deneysel analizi üzerine çalışmalarını yoğunlaşmıştır. Bu iki çalışma grubun konularının doğal birleşimi sayesinde terahertz teknolojileri için beraber yüksek

Comparison of Intraabdominal and Trocar Site Local Anaesthetic Infiltration on Postoperative Analgesia After Laparoscopic Cholecystectomy

OBJECTIVE: This study aimed to compare the efficacy of local anaesthetic infiltration to trocar wounds and intraperitoneally on postoperative pain as a part of a multimodal analgesia method after laparoscopic cholecystectomies. METHODS: The study was performed on 90 ASA I–III patients aged between 20 and 70 years who underwent elective laparoscopic cholecystectomy. All patients had the same general anaesthesia drug regimen. Patients were randomized into three groups by a closed envelope method: group I (n=30), trocar site local anaesthetic infiltration (20 mL of 0.5% bupivacaine); group II (n=30), intraperitoneal local anaesthetic instillation (20 mL of 0.5%) and group III (n=30), saline infiltration both trocar sites and intraperitoneally. Postoperative i.v. patient controlled analgesia was initiated for 24 h. In total, 4 mg of i.v. ondansetron was administered to all patients. Visual analogue scale (VAS), nausea and vomiting and shoulder pain were evaluated at 1., 2., 4., 8., 12., 24. hours. An i.v. nonsteroidal anti-inflammatory drug (NSAID) (50 mg of dexketoprofen) as a rescue analgesic was given if the VAS was ≥5. RESULTS: There were no statistical significant differences between the clinical and demographic properties among the three groups (p≥0.005). During all periods, VAS in group I was significantly lower than that in groups II and III (p<0.001). Among the groups, although there was no significant difference in nausea and vomiting (p=0.058), there was a significant difference in shoulder pain. Group III (p<0.05) had more frequent shoulder pain than groups I and II. The total morphine consumption was higher in groups II and III (p<0.001 vs p<0.001) than in group I. The requirement for a rescue analgesic was significantly higher in group III (p<0.05). CONCLUSION: Trocar site local anaesthetic infiltration is more effective for postoperative analgesia, easier to apply and safer than other analgesia methods. Morphine consumption is lesser and side effects are fewer; therefore, this method can be used as a part of common practice

Spinal Anaesthesia with Hyperbaric Prilocaine in Day-Case Perianal Surgery: Randomised Controlled Trial

Background. The local anaesthetics used in day-case spinal anaesthesia should provide short recovery times. We aimed to compare hyperbaric prilocaine and bupivacaine in terms of sensory block resolution and time to home readiness in day-case spinal anaesthesia. Methods. Fifty patients undergoing perianal surgery were randomized into two groups. The bupivacaine-fentanyl group (Group B) received 7.5 mg, 0.5% hyperbaric bupivacaine + 20 μg fentanyl in total 1.9 mL. The prilocaine-fentanyl group (Group P) received 30 mg, 0.5% hyperbaric prilocaine + 20 μg fentanyl in the same volume. Results. Time to L1 block and maximum block was shorter in Group P than in Group B (Group P 4.6±1.3 min versus Group B 5.9±01.9 min, P=0.017, and Group P 13.2±7.5 min versus Group B 15.3±6.6 min, P=0.04). The time to L1 regression and S3 regression of the sensorial block was significantly shorter in Group P than in Group B (45.7±21.9 min versus 59.7±20.9 min, P=0.024, and 133.8±41.4 min versus 200.4±64.8 min, P<0.001). The mean time to home readiness was shorter for Group P than for Group B (155±100.2 min versus 207.2±62.7 min (P<0.001)). Conclusion. Day-case spinal anaesthesia with hyperbaric prilocaine + fentanyl is superior to hyperbaric bupivacaine in terms of earlier sensory block resolution and home readiness and the surgical conditions are comparable for perianal surgery