Anesthesic Management for Escobar Syndrome: Case Report

Escobar syndrome is a rare autosomal recessive disorder which is characterized by growth retardation, axillary, antecubital, popliteal digital, and intercrural joint flexion contracture, pterygium in the eyes, cleft palate, decreased lung capacity, genital abnormalities, and spinal deformity. In this case, we presented the anesthesic management of a 2-year-old child undergoing frontal sling operation for ptosis and amblyopia etiology exploration

Comparison of sedation effectiveness of remifentanil-dexmedetomidine and remifentanil-midazolam combinations and their effects on postoperative cognitive functions in cystoscopies: A randomized clinical trial

Background: The aim of the study is to compare the effects of remifentanil/dexmedetomidine and remifentanil/midazolam combinations in monitored anesthesia care (MAC) during cystoscopies. Materials and Methods: Forty patients who received remifentanil infusion of 0.05 μg kg-1 min -1 for cytoscopy procedure were randomized into two groups: Either dexmedetomidine 1 mg kg -1 (Group D) or midazolam 0.2 mg kg -1 h -1 (Group M) was administered intravenously for the first 10 min. Subsequently, anesthesia was maintained by using the bispectral index as a continuous infusion of dexmedetomidine (0.2-0.7 μg kg-1 h -1) or midazolam (0.05-0.15 μg kg-1 h -1 ). Heart rate, mean arterial pressure, mini-mental state examination findings, levels of sedation andanalgesia, and the patient′s and surgeon′s satisfaction were recorded. Results: Successful sedation and analgesia were achieved in all the patients. We were able to reach the target sedation level faster in Group D (P<0.0001). In Group D, the cognitive functions were less affected than in Group M (P<0.0001). Patient′s and surgeon′s satisfaction were significantly higher in Group D. Conclusion: The targeted sedation levels were achieved in a shorter period with dexmedetomidine-remifentanil compared to midazolam-remifentanil. The dexmedetomidine-remifentanil combination was observed to affect the cognitive functions less than midazolam-remifentanil did with shorter recovery times. Besides, patient′s and surgeon′s satisfaction rates were superior with dexmedetomidine-remifentanil. It was concluded that dexmedetomidine-remifentanil may be a combination of choice for monitored anesthesia care applications in outpatient surgical procedures of short duration

The evaluation of pulmonary function and blood gas analysis in patients submitted to laparoscopic versus open nephrectomy.

The aim of this study was to assess the early postoperative pulmonary function and arterial blood gases in patients who have undergone open versus laparoscopic nephrectomy

The Effects of High Dose Sugammadex on Rat Kidney Tissue Following Unilateral Ureteral Obstruction

Arslan, Mustafa/0000-0003-4882-5063WOS: 000445290000003Background: Unilateral ureteral obstruction (UUO) is commonly used model showed to imitate process of obstructive nephropathy in a feasible. The aim of this study is to evaluate the histopathological and biochemical effects of high doses sugammadex on kidney tissue of the rats those have early and late phase renal failure induced by UUO. Materials and Methods: Thirty male Wistar albino rats were randomly divided into five study groups. Control Group(C), UUO for 1 week Group(UUO-1), UUO-1 week treated with rocuronium and 96mg.kg(-1) Sugammadex Group(UUO-1 week-96S), UUO for 3 weeks Group(UUO-3) and UUO-3 weeks treated with rocuronium and 96mg.kg(-1 )Sugammadex Group(UUO-3 week-96S). The blood samples are stored at -20 degrees and MDA and NO were studied in the serum. Kidney tissue was removed for histopathological examination. Results: In the histopathological examination of all parameters (glomerular vacuolization(GV), tubular dilatation(TD), Vascular vacuolisation and hypertrophy(VVH), tubular cell degeneration and necrosis(TCDN), Bowman's space dilatation(BSD), tubular hyaline cylinders(THC), lymphocyte infiltration(LI), tubular cell sloughing(TCS), significant difference was observed for the kidney at the obstruction side. After 3 weeks, in the side of the all unobstructed groups' kidney tissues, significantly higher GV scores were detected compared with the GroupC. TD was observed more for the UUO1, UUO3 and UUO3S groups when compared with GroupC. And TCDN was observed more for the UUO1S and UUO3S groups when compared with GroupC. When the groups were compared with each other; it is observed that MDA and NO enzyme activities of UUO1S, UUO3 and UUO3S groups were significantly difference GroupC. Conclusion: High dose of sugammadex (96 mg.kg(-1)) can be used safely in UUO cases, on the other hand significant attention should be paid in bilateral ureteral obstruction cases. Our findings may be a guide for future animal and human studies investigating the effects of sugammadex on kidney tissue

The evaluation of pulmonary function and blood gas analysis in patients submitted to laparoscopic versus open nephrectomy

Background: The aim of this study was to assess the early postoperative pulmonary function and arterial blood gases in patients who have undergone open versus laparoscopic nephrectomy. Materials and Methods: Forty patients were randomly assigned to undergo laparoscopic (LN, n=20) or open nephrectomy (ON, n=20). Pulmonary function tests including forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), forced expiratory volume at 25\% (FEF25), forced expiratory volume at 50\% (FEF50), forced expiratory volume at 25\% to 75\% (FEF25-75), forced expiratory volume in 1 second (FIV1) and peak expiratory flow (PEF) were performed one day before the operation and on the postoperative day 1. The arterial blood gas analysis (pH, pCO(2), pO(2), SaO(2)) was made at breathing room preoperatively, in the recovery phase and on postoperative day 1. Results: All spirometric variables decreased after both open and laparoscopic nephrectomy on postoperative day 1. FEV1, FVC, FEF25 and FEF25-75 values decreased on postoperative day 1 (39.7\%, 37.4\%, 27.7\%, 51.8\% respectively) in the open surgery group and they were significantly lower in laparoscopic group (29.9\%, 32.5\%, 23.2\%, 44.5\% respectively). There were no significant differences in FEF50, PEF and FIV1 between the groups. The SaO(2) and pO(2) values also decreased in both groups. During early recovery, pH decreased while pCO(2) increased significantly but they returned to preoperative values on postoperative day 1 in both groups. Conclusion: Laparoscopic nephrectomy is better than open nephrectomy considering pulmonary functions

Comparison Of The Effects Of Dexmedetomidine Vs. Ketamine In Cardiac Ischemia/Reperfusion Injury In Rats - Preliminary Study

Objectives. Following ischemia/reperfusion injury, antioxidant defense mechanisms may remain insufficient depending on the duration of ischemia which is caused by any reason (MI, after percutaneous coronary intervention, during cardiac surgery). After that, free oxygen radicals increasing within the cell cause structural deterioration. Cytokines which activate a series of reactions that cause tissue damage and inflammatory response are released during reperfusion of ischemic tissues. In this study, we aimed to compare the effects of dexmedetomidine and ketamine in cardiac ischemia/reperfusion injury. Material and Methods. The study included 18 rats randomly divided into three groups. Group I/R (n = 6): control, Group I/R-K (n = 6): ketamine, and Group I/R-D (n = 6): dexmedetomidine. Before the 10 min surgery, after the 20 min ischemia and 20 min reperfusion period, hemodynamic parameters were compared among the three groups. After the 45 min ischemia and 120 min reperfusion period, tissue samples were obtained from the rat hearts, and MDA, SOD, GSH-Px, IL-1 beta and TNF-alpha levels were compared. Results. MDA and GSH-Px levels were significantly higher in the control group compared to the ketamine and dexmedetomidine groups. However, both levels were similar in the ketamine and dexmedetomidine groups. SOD levels were significantly lower in the ketamine and dexmedetomidine groups compared to the control group, but they were similar in the ketamine and dexmedetomidine groups. IL-1 beta levels were similar in all groups. TNF-alpha levels were significantly lower in the ketamine and dexmedetomidine groups compared to the control group. They were similar in the ketamine and dexmedetomidine groups. Conclusions. According to our study, it can be concluded that dexmedetomidine and ketamine have similar effects on reducing myocardial ischemia reperfusion injury. Dexmedetomidine provides better heart rate control but causes hypotension, so, because of cardiac depression, we think that its clinical use may necessitate further investigationWoSScopu