A comparison of two different doses of morphine added to spinal bupivacaine for inguinal hernia repair

ABSTRACT BACKGROUND AND OBJECTIVES: The aim of this study was to compare the effects of two different doses of intrathecal morphine on postoperative analgesia, postoperative first mobilization and urination times and the severity of side effects. METHODS: After Institutional Ethical Committee approval, 48 ASA I-II patients were enrolled in this randomized double-blinded study. Spinal anesthesia was performed with 0.1 mg (Group I, n = 22) or 0.4 mg (Group II, n = 26) ITM in addition to 7.5 mg heavy bupivacaine. The first analgesic requirement, first mobilization and voiding times, and postoperative side effects were recorded. Statistical analyses were performed using SPSS 15.0 and p < 0.05 was considered as statistically significant. The numeric data were analyzed by thet-test and presented as mean ± SD. Categorical data were analyzed with the chi-square test and expressed as number of patients and percentage. RESULTS: Demographic data were similar among groups. There were no differences related to postoperative pain, first analgesic requirements, and first mobilization and first voiding times. The only difference between two groups was the vomiting incidence. In Group II 23% (n = 6) of the patients had vomiting during the first postoperative 24 h compared to 0% in Group I (p = 0.025). CONCLUSION: For inguinal hernia repairs, the dose of 0.1 mg of ITM provides comparable postoperative analgesia with a dose of 0.4 mg, with significantly lower vomiting incidence when combined with low dose heavy bupivacaine

Single-port Laparoscopic Surgery by Use of a Surgical Glove Port: Initial Experience with 25 Cases

Rezumat Chirurgie laparoscopicã cu un singur port folosind &quot;port mãnuaeã chirurgicalã&quot;: primul studiu pe 25 de cazuri Premize: chirurgia laparoscopicã cu un singur port a câştigat popularitate în ultimii zece ani. Aceastã tehnicã este folositã în unele proceduri chirurgicale. Acest articol descrie o metodã nouã şi mai ieftinã, cunoscutã sub numele de &quot;portul mãnuşã chirurgicalã (PMC)&quot; sau &quot;port improvizat&quot; şi explicã studiul efectuat pe 25 de cazuri. Metodã: s-au efectuat unsprezece colecistectomii, reparaåia la opt hernii inghinale prin procedeu total extraperitoneal, trei splenectomii, douã rezecåii gastrice şi o procedurã anti-reflux. Rezultate: Douãzeci şi patru de proceduri din douãzeci şi cinci, au fost finalizate fãrã sã fie convertite la intervenåie deschisã sau multi-port. La un pacient care prezenta atât litiaza biliarã cât şi tumora gastrointestinalã stromalã, s-au efectuat în aceeaşi sesiune şi colecistectomie şi rezecåie gastricã parcelarã prin tehnica laparoscopicã cu un singur port &quot;mãnuşa chirurgicalã&quot;. La un alt caz, au fost efectuate douã incizii suplimentare de câte 5 mm pentru hemostazã. Pentru cazul de reparaåie a herniei hiatale, a fost necesarã o intervenåie chirurgicalã suplimentarã pentru hemoragie postoperatorie, care a fost efectuatã prin aceeasi tehnicã cu port mãnuşã chirurgicalã. Concluzie: Chirurgia laparoscopicã cu un singur port este o tehnicã care poate fi aplicatã în cazul multor proceduri chirurgicale. PMC este o tehnicã mai nouã, pentru care unele experiente preliminare sunt deja publicate în întreaga lume. Tehnica PMC are unele avantaje cum ar fi: cost-eficienåã, implantare uşoarã şi sigurã a portului şi extracåia uşoarã a pieselor chirurgicale. De asemenea poate fi utilizatã şi pentru tratamentul complicaåiilor postoperatorii. Cuvinte cheie: laparoscopie cu un singur port, laparoscopie cu port mãnuşã chirurgicalã, depãrtãtor Alexis Abstract Background: single-port laparoscopic surgery has gained popularity over the last decade. This technique is used for several surgical procedures. This paper documents a new and cheaper access method known as &quot;surgical glove port&quot; or &quot;homemade single-port&quot;, and describes our initial experience with 25 cases. Method: Eleven cholecystectomies, eight totally extraperitoneal inguinal hernia repairs, three splenectomies, two gastric wedge resections, and one anti-reflux procedure were performed. Results: Twenty-four procedures out of twenty-five were completed without conversion to open or multiple port techniques. An individual patient who had both cholelithiasis and gastrointestinal stromal tumor underwent both cholecystectomy and gastric wedge resection in the same session with surgical glove port technique. In another case two additional 5-mm incisions were made for hemostasis. The additional operation was required and performed by using surgical glove port for a hiatal hernia repair case, because of postoperative hemorrhage. Conclusion: Single-port laparoscopic surgery is an applicable technique for plenty of surgical procedures. Also, surgical Corresponding author: Atil Cakmak, MD Ankara Universitesi Tıp Fakultesi Ibni Sina Hastanesi Akademik Yerleske K4 06100 Sıhhıye Ankara Turkey E-mail: [email protected] glove port is a newer technique and some initial experiences have already published all over the world. Surgical glove port has advantages such as cost-effectiveness, easy and safe port implantation and specimen extraction. SGP can also be used for treating post-operative complications

Clinical and molecular evaluation of MEFV gene variants in the Turkish population: a study by the National Genetics Consortium

Familial Mediterranean fever (FMF) is a monogenic autoinflammatory disorder with recurrent fever, abdominal pain, serositis, articular manifestations, erysipelas-like erythema, and renal complications as its main features. Caused by the mutations in the MEditerranean FeVer (MEFV) gene, it mainly affects people of Mediterranean descent with a higher incidence in the Turkish, Jewish, Arabic, and Armenian populations. As our understanding of FMF improves, it becomes clearer that we are facing with a more complex picture of FMF with respect to its pathogenesis, penetrance, variant type (gain-of-function vs. loss-of-function), and inheritance. In this study, MEFV gene analysis results and clinical findings of 27,504 patients from 35 universities and institutions in Turkey and Northern Cyprus are combined in an effort to provide a better insight into the genotype-phenotype correlation and how a specific variant contributes to certain clinical findings in FMF patients. Our results may help better understand this complex disease and how the genotype may sometimes contribute to phenotype. Unlike many studies in the literature, our study investigated a broader symptomatic spectrum and the relationship between the genotype and phenotype data. In this sense, we aimed to guide all clinicians and academicians who work in this field to better establish a comprehensive data set for the patients. One of the biggest messages of our study is that lack of uniformity in some clinical and demographic data of participants may become an obstacle in approaching FMF patients and understanding this complex disease