Anaesthetic Management for Caesarean Section Surgery in Two Pregnant Women with Severe Pulmonary Hypertension Due to Mitral Valve Stenosis

Background: Mitral stenosis is the most important and common cardiac complication seen during pregnancy. Conception is discouraged in cases where pulmonary hypertension develops during the course of mitral stenosis. Successful general and regional anaesthetic interventions have been reported in some cases of severe pulmonary hypertension. Case Reports: We present our experiences with anaesthetic management in two pregnant patients with pulmonary hypertension due to mitral valve stenosis. Conclusion: We preferred to continue spinal anaesthesia because gradually increasing the local anaesthetic dose during the procedure may minimise probable undesirable haemodynamic changes, such as hypotension and tachycardia

The effects of desflurane and remifentanyl anaesthesia compared to lumbar epidural analgesia combined with desflurane on recovery

Objective: Our primary objective in this study is to compare the effects of the applications of desflurane and remifentanyl anaesthesia, along with lumbar epidural analgesia combined with desflurane on postoperative recovery in the cases who undergoing lower abdominal surgery. Methods: This study performed 240 patients who undergoing elective lower abdominal surgery. Patients were divided into two random groups as Group DR (desflurane + remifentanyl n=120) and Group DL (desflurane +Lumbar Epidural Analgesia n=120).The general anaesthesia in Group DR was performed through the use of desflurane and remifentanyl. Group DL was administered a general anaesthesia through a pre-operative epidural catheter insertion and an application of desflurane. Extubation, eye opening, head lift for 5 seconds, and the surgical durations of the patients as well as the postoperative side-effects were recorded. Modified Aldrete Scoring System was used to assess the recovery of the patients from anaesthesia. Results: According to the inter group comparison results between Group DR and Group DL, the duration of extubation, eye opening, head lift for 5 seconds and the average amount of elapsed time until the modified Aldrete Scoring reached 10 were found statistically and significantly shorter in Group DL than Group DR( respectively p=0.002, p<0.001, p<0.001, p<0.001).The duration of the first analgesic need was statistically and significantly longer in Group DL compared to Group DR (p<0.001). The postoperative patient satisfaction in Group DL was statistically and significantly higher than that in Group DR (p=0.010). Conclusion: The Epidural analgesia included in the general anaesthesia in lower abdominal surgery is considered by us to be the beneficial and efficient method of analgesia which leads to an earlier recovery of the patients without affecting the intraoperative hemodynamic stability and which boosts the patient satisfaction by providing a more efficient analgesia during the postoperative period

The suppression of endogenous adrenalin in the prolongation of ketamine anesthesia

Cetin, Nihal/0000-0003-3233-8009; Ahiskalioglu, Ali/0000-0002-8467-8171; Ahiskalioglu, Ali/0000-0002-8467-8171; ALP, Hamit Hakan/0000-0002-9202-4944; AKSOY, Mehmet/0000-0003-0867-8660WOS: 000337884400022PubMed: 24767810This study investigated whether or not the anesthetic effect of ketamine in rats is dependent on adrenal gland hormones. the study was performed on two main rat groups, intact and adrenalectomized. Rat were divided into subgroups and given appropriate doses of ketamine, metyrapone or metyrosine. Durations of anesthesia in the groups were then recorded. Endogenous catecholamine levels were measured in samples taken from peripheral blood. This experimental results showed that ketamine did not induce anesthesia in intact rats at doses of 15 or 30 mg/kg, and that at 60 mg/kg anesthesia was established for only 11 min. However, ketamine induced significant anesthesia even at a dose of 30 mg/kg in animals in which production of endogenous catecholamine (adrenalin, noradrenalin dopamine) was inhibited with metyrosine at a level of 45-47%. Ketamine at 60 mg/kg in animals in which endogenous catecholamine was inhibited at a level of 45-47% established anesthesia for 47.6 min. However, ketamine at 30 and 60 mg/kg induced longer anesthesia in adrenalectomized rats with higher noradrenalin and dopamine levels but suppressed adrenalin production. Adrenalin plays an important role in the control of duration of ketamine anesthesia, while noradrenalin, dopamine and corticosterone have no such function. If endogenous adrenalin is suppressed, ketamine can even provide sufficient anesthesia at a 2-fold lower dose. This makes it possible for ketamine to be used in lengthy surgical procedures. (C) 2014 Elsevier Ltd. All rights reserved

Comparative investigation of protective effects of metyrosine and metoprolol against ketamine cardiotoxicity in rats

Ahiskalioglu, Ali/0000-0002-8467-8171; ALP, Hamit Hakan/0000-0002-9202-4944; Ahiskalioglu, Ali/0000-0002-8467-8171; AKSOY, Mehmet/0000-0003-0867-8660WOS: 000361605900005PubMed: 25503950This study investigated the effect of metyrosine against ketamine-induced cardiotoxicity in rats and compared the results with the effect of metoprolol. in this study, rats were divided into groups A, B and C. in group A, we investigated the effects of a single dose of metyrosine (150 mg/kg) and metoprolol (20 mg/kg) on single dose ketamine (60 mg/kg)-induced cardiotoxicity. in group B, we investigated the effect of metyrosine and metoprolol, which were given together with ketamine for 30 days. in group C, we investigated the effect of metyrosine and metoprolol given 15 days before ketamine and 30 days together with ketamine on ketamine cardiotoxicity. By the end of this process, we evaluated the effects of the levels of oxidant-antioxidant parameters such as MDA, MPO, 8-OHGua, tGSH, and SOD in addition to CK-MB and TP I on cardiotoxicity in rat heart tissue. the experimental results show that metyrosine prevented ketamine cardiotoxicity in groups A, B and C and metoprolol prevented it in only group C