Comparison of the Proseal, Supreme, and I-Gel SAD in Gynecological Laparoscopic Surgeries

We compared proseal, supreme, and i-gel supraglottic airway devices in terms of oropharyngeal leak pressures and airway morbidities in gynecological laparoscopic surgeries. One hundred and five patients undergoing elective surgery were subjected to general anesthesia after which they were randomly distributed into three groups. Although the oropharyngeal leak pressure was lower in the i-gel group initially (mean ± standard deviation; 23.9 ± 2.4, 24.9 ± 2.9, and 20.9 ± 3.5, resp.), it was higher than the proseal group and supreme group at 30 min of surgery after the trendelenburg position (25.0 ± 2.3, 25.0 ± 1.9, and 28.3 ± 2.3, resp.) and at the 60 min of surgery (24.2 ± 2.1, 24.8 ± 2.2, and 29.5 ± 1.1, resp.). The time to apply the supraglottic airway devices was shorter in the i-gel group (12.2 (1.2), 12.9 (1.0), and 6.7 (1.2), resp., P=0.001). There was no difference between the groups in terms of their fiber optic imaging levels. pH was measured at the anterior and posterior surfaces of the pharyngeal region after the supraglottic airway devices were removed; the lowest pH values were 5 in all groups. We concluded that initial oropharyngeal leak pressures obtained by i-gel were lower than proseal and supreme, but increased oropharyngeal leak pressures over time, ease of placement, and lower airway morbidity are favorable for i-gel

Clinical Study Comparison of the Proseal, Supreme, and I-Gel SAD in Gynecological Laparoscopic Surgeries

We compared proseal, supreme, and i-gel supraglottic airway devices in terms of oropharyngeal leak pressures and airway morbidities in gynecological laparoscopic surgeries. One hundred and five patients undergoing elective surgery were subjected to general anesthesia after which they were randomly distributed into three groups. Although the oropharyngeal leak pressure was lower in the i-gel group initially (mean ± standard deviation; 23.9 ± 2.4, 24.9 ± 2.9, and 20.9 ± 3.5, resp.), it was higher than the proseal group and supreme group at 30 min of surgery after the trendelenburg position (25.0 ± 2.3, 25.0 ± 1.9, and 28.3 ± 2.3, resp.) and at the 60 min of surgery (24.2 ± 2.1, 24.8 ± 2.2, and 29.5 ± 1.1, resp.). The time to apply the supraglottic airway devices was shorter in the i-gel group (12.2 (1.2), 12.9 (1.0), and 6.7 (1.2), resp., = 0.001). There was no difference between the groups in terms of their fiber optic imaging levels. pH was measured at the anterior and posterior surfaces of the pharyngeal region after the supraglottic airway devices were removed; the lowest pH values were 5 in all groups. We concluded that initial oropharyngeal leak pressures obtained by i-gel were lower than proseal and supreme, but increased oropharyngeal leak pressures over time, ease of placement, and lower airway morbidity are favorable for i-gel

Dexmedetomidine improves ultrastructural view of renal damage and biochemical parameters during an experimental inflammatory bowel disease

Investigation of the effect of Dexmedetomidine (Dex) on inflammatory bowel diseases (IBD) induced renal damage by using an experimental model. IBD frequently cause reduction in renal function and renal failure. Since perioperative anesthesia and postoperative conditions in intensive care can cause acute kidney injury and reduction on renal function; deciding on a sedative and anesthetic agent without side effects would reduce IBD caused renal damage. We investigated histopathological, electron microscopic analyzes and antioxidant effects of Dex on kidney tissue during trinitrobenzene sulfonic acid (TNBS) induced damage in BALB/c mice at two different concentrations of Dex; 5μg/kg and 30μg/kg. Blood samples were collected to analyze creatinine levels. The levels of malondialdehyde (MDA) and activity of antioxidant enzymes glutathione (GSH) and superoxide dismutase (SOD) were measured in tissue homogenates. Histopathological and ultrastructural changes in kidney following TNBS induction were significantly reduced in Dex treatment groups. Administration of Dex significantly reduced creatinine levels. MDA levels were significantly reduced in Dex groups. Administration of Dex brought back GSH level to control level. Administration of Dex significantly 1.48 and 1.96 times increased SOD activity at 5μg/kg and 30 μg/kg, respectively. Dexmedetomidine treatment may have benefits to prevent IBD induced renal damage. [Med-Science 2018; 7(3.000): 594-9

Performance of Size 1 I-Gel Compared with Size 1 ProSeal Laryngeal Mask in Anesthetized Infants and Neonates

Purpose. The size 1 I-gel, recommended for small infants and neonates weighing 2–5 kg, has recently been released. There are no prospective studies available that assess the insertion conditions, sealing pressures, or ventilation quality of it. This study was designed to compare the performance of recently released size 1 I-gel with size 1 ProSeal LMA. Methods. Fifty infants and neonates, ASA I-II were included in this prospective, randomized, and controlled study. Patients were divided into two groups for placing I-gel or ProSeal LMA. The primary outcome was airway leak pressure, and secondary outcomes included insertion time, insertion success and conditions, initial airway quality, fiberoptic view of the larynx, and complications. Results. There were no significant differences in terms of airway leak pressure between the I-gel (27.44±5.67) and ProSeal LMA (23.52±8.15) (P=0.054). The insertion time for the I-gel was shorter (12.6±2.19 s) than for the ProSeal LMA (24.2±6.059 s) (P=0.0001). Insertion success and conditions were similar in groups. We encountered few complications. Conclusion. Our study demonstrates that the size 1 I-gel provided an effective and satisfactory airway as the size 1 ProSeal LMA. It may be a good alternative supraglottic airway device for use in small infants and neonates. This trial is registered with: ClinicalTrials.gov NCT01704118

Reliability and validity of the Turkish version of oral health impact profile for edentulous subjects

Purpos

Effects on hypotension incidence: Hyperbaric, isobaric, and combinations of bupivacaine for spinal anesthesia in cesarean section [Hipotansiyon insidansı üzerine etkiler: Sezaryen için spinal anestezide hiperbarik, isobarik bupivakain ve kombinasyonları]

Aim: To determine if hypotension frequency changes when hyperbaric or isobaric formulations of bupivacaine, or their sequential administrations, are used for cesarean section. Hypotension after spinal anesthesia for cesarean section is common. Materials and methods: A total of 144 patients who were to undergo cesarean section with spinal anesthesia were allocated into 4 groups. Spinal anesthesia was achieved with 10 mg of hyperbaric bupivacaine in Group H10, sequential 5-mg administrations of hyperbaric and isobaric bupivacaine in Group H5P5, sequential 5-mg administrations of isobaric and hyperbaric bupivacaine in Group P5H5, and 10 mg of isobaric bupivacaine in Group P10. Hemodynamic parameters were determined and the incidence of hypotension, incidence of bradycardia, and amount of ephedrine required to treat hypotension were recorded. Fetal Apgar scores, the pH of the umbilical cord blood, and side effects were also noted. Results: American Society of Anesthesiologists risk group, surgical duration, and demographic values were similar among the groups. The incidence of hypotension was found to be 69.4%, 66.7%, 75.0%, and 83.3% in the H10, H5P5, P10, and P5H5 groups, respectively. The incidences of hypotension were not significantly different. Bradycardia incidence, ephedrine consumption, the pH of cord blood, and side effects were not different among the groups. Conclusion: When the dose of local anesthetic is the same, the incidence of spinal-induced hypotension cannot be lowered using hyperbaric, isobaric, or sequential injections of a half dose of bupivacaine for spinal anesthesia during cesarean section. © TÜBİTAK

Arterial Stiffness Measured Via Carotid Femoral Pulse Wave Velocity Is Associated With Disease Severity in COPD

Ozkaya, Sevket/0000-0002-8697-4919; Durakoglugil, Emre/0000-0001-5268-4262; KAYHAN, SERVET/0000-0003-4226-2781; Erdogan, Turan/0000-0003-2986-5457WOS: 000331427800015PubMed: 23821765BACKGROUND: Patients with COPD face an increased risk of cardiovascular disease and increased cardiac mortality. Carotid femoral pulse wave velocity (cf-PWV) is a validated measure of arterial stiffness, a well recognized predictor of adverse cardiovascular outcomes, and offers higher predictive value than classical cardiovascular risk factors. We investigated the association between COPD and arterial stiffness using cf-PWV as a noninvasive technique. METHODS: This clinical study was prospective, observational, and cross-sectional. Sixty-two subjects with stable COPD and 22 healthy controls underwent physical examination, chest x-rays, pulmonary function tests, arterial blood gas analysis, and 6-min walk test, and cf-PWV was measured via a validated tonometry system. RESULTS: the COPD subjects had greater arterial stiffness than the control subjects, and that difference was associated with lower FEV1, P-aO2, and oxygen saturation during the 6-min walk test. We observed higher cf-PWV in the COPD subjects with severe COPD than in the subjects with mild to moderate COPD. Only FEV1 was an independent predictor of cf-PWV. CONCLUSIONS: Our results suggest that arterial stiffness is increased in subjects with more severe and advanced COPD than in those with mild to moderate COPD. Air flow limitation and hypoxemia may induce increased arterial stiffness in COPD patients