The efficacy of intrathecal morphine with bupivacaine for postoperative analgesia after TUR-B

15th World-Federation-of-Societies-of-Anaesthesiologists (WFSA) World Congress of Anaesthesiologists -- MAR 25-30, 2012 -- Buenos Aires, ARGENTINAWOS: 000302299100668World Federat Soc Anaesthesiol (WFSA

İntratekal Bupivakain İle Morfinin TUR-M Sonrası Postoperatif Analjeziye Etkisi

Objective: In this randomized study, we evaluated two different doses of intrathecal (IT) morphine with bupivacaine for analgesia after transurethral resection of bladder (TUR-B). Material and Method: Seventy-five patients were randomly divided into three groups. They were allocated to receive IT morphine (100 µg) with 12.5 mg 0.5% bupivacaine (Group 1), IT morphine (200 µg) with 12.5 mg 0.5% bupivacaine (Group 2), and IT 12.5 mg 0.5% bupivacaine without morphine (Group 3). Postoperative pain was evaluated by VAS during 24 h and each patient was given intravenous paracetamol and Dexketoprophen trometamol if pain severity was moderate. Results: VAS scores were significantly lower in Groups I and II than Group III at 1h, 2h, 4h, 6h, 12h (p< 0.05) (Figure 1). The request for analgesia was significantly higher in Group III than the other two groups (p< 0.05). More patients reported postoperative nausea in Group II than the other two groups (p< 0.05) (Figure 2). Conclusion: IT morphine (100 µg and 200 µg) with 12.5 mg 0.5% provided a significant reduction in postoperative pain scores compared to IT 12.5 mg 0.5% bupivacaine alone. IT morphine 100 µg provided comparable postoperative pain control with significantly lower side effects than IT morphine 200 µg after TUR-B.Amaç: Bu randomize çalışmada transüretral mesane rezeksiyonu (TUR-M) sonrası analjezi için bupivakain ile iki farklı intratekal (IT) morfin dozu değerlendirildi. Gereç ve Yöntem: Yetmiş beş hasta rastgele üç gruba ayrıldı. IT morfin (100 ug) ile 12,5 mg %0,5 bupivakain (1. Grup), IT morfin (200 ug) ile 12,5 mg %0,5 bupivakain (2. Grup) ve morfinsiz IT 12,5 mg %0,5 bupivakain (3. Grup) alanlar olarak. Postoperatif ağrı 24 saat boyunca VAS ile değerlendirildi ve ağrı şiddeti orta derecede olan her hastaya intravenöz parasetamol ve Dexketoprophen trometamol verildi. Bulgular: Grup I ve II'de VAS skorları 1 saat, 2 saat, 4 saat, 6 saat, 12 saatte Grup III'e göre anlamlı olarak düşüktü (p<0.05). Analjezi talebi Grup III'te diğer iki gruba göre anlamlı derecede yüksekti (p< 0.05). Grup II'de postoperatif bulantı, diğer iki gruba göre daha fazla rapor edildi (p<0.05). Sonuç: IT %12,5 mg %0,5 bupivakain ile morfin (100 ug ve 200 ug), yanlız IT %12,5 mg %0,5 bupivakain’e kıyasla postoperatif ağrı skorlarında anlamlı bir azalma sağladı. TUR-M sonrasında postoperatif ağrı kontrolünde IT 100 ug morfin, IT 200 ug morfinden önemli ölçüde karşılaştırılabilir daha düşük yan etkiler sağladı

Characterization of morphological traits of local and global persimmon varieties and genotypes collected from Turkey

Genetic variations are highly important in terms of plant breeding. These variations occur either spontaneously or artificially by mutations and sexual hybridizations in order to achieve specific breeding objectives. In this study, persimmon genetic resources collected from Turkey and preserved ex situ with commercial cultivars in a germplasm orchard located at Çukurova University, Turkey, were characterized based on their morphological traits. The collection was composed of traditional genotypes and local accessions together with global varieties. For the morphological characterization, 59 morphological and agronomic traits were investigated: 9 related to plant growth, 5 to leaf characteristics, 7 to flower traits, 32 to fruit traits, and 6 to seed traits. Moreover, the data obtained in this process were subjected to similarity coefficient, principal component, and cluster analyses to demonstrate the overall phenotypic relationships among these genotypes. The cumulative proportion of variation reached 39.04% with the first three PCA axes. The first component was based on shoot length, trunk surface structure, flowering time of female flowers, fruit length, and diameter. The twelve factor scores represented 74.75% of the total multivariate variation, and cluster analysis indicated that the similarity index of the population consisting of the investigated genotypes ranged between 81.09% and 17.32%

Radikal retropubik prostatektomi için yapılan intratekal morfin analjezisi sonrası kraniyal tümör teşhisi

Management of postoperative headache which developed after radical retropubic prostatectomy under general anesthesia and intrathecal morphine for postoperative analgesia was presented in this case. The patient, who received intrathecal morphine for postoperative analgesia, had nonpostural headache. After numbness at left part of his face and 4/5 paresis on his left extremities developed a month later. Following neurological examination, computed tomography of the brain revealed a posterior parieto-occipital mass. The mass removed by a craniotomy was medulloblastoma. If there is nonpostural headache after lumbar puncture, detailed clinical and radiological evaluation is important for to detect possible intracranial events.Bu olgu sunumunda genel anestezi altında radikal retropubik prostatektomi geçiren ve postoperatif analjezi için intratekal morfin uygulanan bir olguda postoperatif gelişen baş ağrısına yaklaşım sunulmuştur. Postoperatif analjezi amacıyla intratekal morfin uygulanan olguda hastanın konumuyla ilişkili olmayan baş ağrısı başladı, 1 ay sonra yüzünün sol tarafında duyu kaybı ve sol ekstremitelerinde 4/5 güçsüzlük gelişti. Nörolojik bakı ve bilgisayarlı tomografi sonrası sağ arka parietooksipital kitle tanısı kondu. Kranyotomiyle çıkarılan kitlenin medulloblastom olduğu anlaşıldı.. Sonuç olarak lomber ponksiyon sonrası konuma bağlı olmayan baş ağrısı var ise kafaiçi oluşum için ayrıntılı klinik ve radyolojik değerlendirme yapılmasının uygun olacağı düşüncesindeyiz