Hypothermia Frequency of Patients in the Postoperative Period

In this study, we aimed to investigate the frequency of postoperative hypothermia in our hospital.In Kecioren Training and Research Hospital, 165 ASA I-III patients between the ages of 18 and 81, whose operation times were longer than 30 minutes were included in this study. In addition to recording the demographic data of the patients, the body temperatures were also measured twice in the preoperative preparation room, and in the postoperative care unit in the forehead with infrared thermometers. The operation types, the durations, the anesthesia types, and the patients heating status in the perioperative period were recorded. If the body temperature was 35oC or below, it was accepted as hypothermia; and if it was 34oC and below, it was accepted as deep hypothermia. We compared the data of normothermic, hypothermic and deep hypothermic patients. 79 women (47.9%) and 86 men (52.1%), totally 165 patients were included in this study. It was detected that 7 patients (4.2%) were heated preoperatively. It was determined that 16 patients (9.7%) were hypothermic in the postoperative period, and 3 of them were deep hypothermic. There were no statistically meaningful differences between the hypothermic and non-hypothermic patients in terms of age, gender, ASA, type of anesthesia, and operation time (p>0.05). Although postoperative hypothermia has not been found as a common problem in our operating theaters, we observed that most of the postoperative hypothermia cases were in percutaneous urological operations. In order to reduce the frequency of postoperative hypothermia, specific precautions for this type of operations should be taken. [Med-Science 2016; 5(1.000): 169-78

Effect of intraoperative esmolol infusion on anesthetic, analgesic requirements and postoperative nausea-vomitting in a group of laparoscopic cholecystectomy patients

PURPOSE: Postoperative pain and nausea/vomitting (PNV) are common in laparoscopic cholecystectomy patients. Sympatholytic agents might decrease requirements for intravenous or inhalation anesthetics and opioids. In this study we aimed to analyze effects of esmolol on intraoperative anesthetic-postoperative analgesic requirements, postoperative pain and PNV. METHODS: Sixty patients have been included. Propofol, remifentanil and vecuronium were used for induction. Study groups were as follows; I - Esmolol infusion was added to maintenance anesthetics (propofol and remifentanil), II - Only propofol and remifentanil was used during maintenance, III - Esmolol infusion was added to maintenance anesthetics (desflurane and remifentanil), IV - Only desflurane and remifentanil was used during maintenance. They have been followed up for 24 h for PNV and analgesic requirements. Visual analog scale (VAS) scores for pain was also been evaluated. RESULTS: VAS scores were significantly lowest in group I (p = 0.001-0.028). PNV incidence was significantly lowest in group I (p = 0.026). PNV incidence was also lower in group III compared to group IV (p = 0.032). Analgesic requirements were significantly lower in group I and was lower in group III compared to group IV (p = 0.005). Heart rates were significantly lower in esmolol groups (group I and III) compared to their controls (p = 0.001) however blood pressures were similar in all groups (p = 0.594). Comparison of esmolol groups with controls revealed that there is a significant decrease in anesthetic and opioid requirements (p = 0.024-0.03). CONCLUSION: Using esmolol during anesthetic maintenance significantly decreases anesthetic-analgesic requirements, postoperative pain and PNV

Seizure due to multiple drugs intoxication: a case report

The mechanism of the antidepressant effect of bupropion is not fully understood. Besides, using it in the treatment of depression, it is found to be effective in reducing withdrawal symptoms due to smoking cessation. A 28-year-old female patient with a history of depression was admitted to emergency department an hour after ingestion of bupropion, quetiapine, and levothyroxine in high doses to commit suicide. While accepting her into the Intensive Care Unit, she was awake, alert, disoriented and agitated. After 2 h, the patient had a generalized tonic–clonic seizure. The necessary treatment was given and 9 h later with hemodynamic improvement, the patients’ mental status improved.Bupropion may cause unusual behaviors such as delusions, paranoia, hallucinations, or confusion. The risk of seizure is strongly dose-dependent. We want to emphasize the importance of early gastric lavage and administration of activated charcoal. Resumo: O mecanismo do efeito antidepressivo de bupropiona ainda não está bem esclarecido. Contudo, seu uso no tratamento de depressão revelou ser eficaz para reduzir os sintomas de abstinência relacionados à cessação do tabagismo. Uma paciente do sexo feminino, 28 anos, com história de depressão, deu entrada no setor de emergência uma hora após a ingestão de bupropiona, quetiapina e levotiroxina em doses elevadas para cometer suicídio. Ao ser internada em unidade de terapia intensiva, estava acordada, alerta, desorientada e agitada. Após duas horas, apresentou uma crise tônico-clônica generalizada. O tratamento necessário foi administrado e nove horas mais tarde, com a estabilização hemodinâmica, o estado mental da paciente melhorou.Bupropiona pode causar comportamentos incomuns, incluindo delírios, paranoia, alucinações ou confusão mental. O risco de convulsão é altamente dependente da dose. Queremos enfatizar a importância da lavagem gástrica precoce e da administração de carvão ativado. Keywords: Bupripion, Intensive care unit, Seizure, Palavras-chave: Bupropiona, Unidade de terapia intensiva, Convulsã

Seizure due to multiple drugs intoxication: a case report

Abstract The mechanism of the antidepressant effect of bupropion is not fully understood. Besides, using it in the treatment of depression, it is found to be effective in reducing withdrawal symptoms due to smoking cessation. A 28-year-old female patient with a history of depression was admitted to emergency department an hour after ingestion of bupropion, quetiapine, and levothyroxine in high doses to commit suicide. While accepting her into the Intensive Care Unit, she was awake, alert, disoriented and agitated. After 2 h, the patient had a generalized tonic-clonic seizure. The necessary treatment was given and 9 h later with hemodynamic improvement, the patients’ mental status improved. Bupropion may cause unusual behaviors such as delusions, paranoia, hallucinations, or confusion. The risk of seizure is strongly dose-dependent. We want to emphasize the importance of early gastric lavage and administration of activated charcoal