Induction of anesthesia in coronary artery bypass graft surgery: the hemodynamic and analgesic effects of ketamine

OBJECTIVE: The aim of this prospective, randomized study was to evaluate the hemodynamic and analgesic effects of ketamine by comparing it with propofol starting at the induction of anesthesia until the end of sternotomy in patients undergoing coronary artery bypass grafting surgery. INTRODUCTION: Anesthetic induction and maintenance may induce myocardial ischemia in patients with coronary artery disease. A primary goal in the anesthesia of patients undergoing coronary artery bypass grafting surgery is both the attenuation of sympathetic responses to noxious stimuli and the prevention of hypotension. METHODS: Thirty patients undergoing coronary artery bypass grafting surgery were randomized to receive either ketamine 2 mg.kg-1 (Group K) or propofol 0.5 mg.kg-1 (Group P) during induction of anesthesia. Patients also received standardized doses of midazolam, fentanyl, and rocuronium in the induction sequence. The duration of anesthesia from induction to skin incision and sternotomy, as well as the supplemental doses of fentanyl and sevoflurane, were recorded. Heart rate, mean arterial pressure, central venous pressure, pulmonary arterial pressure, pulmonary capillary wedge pressure, cardiac index, systemic and pulmonary vascular resistance indices, stroke work index, and left and right ventricular stroke work indices were obtained before induction of anesthesia; one minute after induction; one, three, five, and ten minutes after intubation; one minute after skin incision; and at one minute after sternotomy. RESULTS: There were significant changes in the measured and calculated hemodynamic variables when compared to their values before induction. One minute after induction, mean arterial pressure and the systemic vascular resistance index decreased significantly in group P (

Internal Jugular Vein Cannulation: An Ultrasound-Guided Technique Versus a Landmark-Guided Technique

OBJECTIVES: To compare the landmark-guided technique versus the ultrasound-guided technique for internal jugular vein cannulation in spontaneously breathing patients. METHODS: A total of 380 patients who required internal jugular vein cannulation were randomly assigned to receive internal jugular vein cannulation using either the landmark- or ultrasound-guided technique in Bursa, Uludag University Faculty of Medicine, between April and November, 2008. Failed catheter placement, risk of complications from placement, risk of failure on first attempt at placement, number of attempts until successful catheterization, time to successful catheterization and the demographics of each patient were recorded. RESULTS: The overall complication rate was higher in the landmark group than in the ultrasound-guided group (p < 0.01). Carotid puncture rate and hematoma were more frequent in the landmark group than in the ultrasound-guided group (p < 0.05). The number of attempts for successful placement was significantly higher in the landmark group than in the ultrasound-guided group, which was accompanied by a significantly increased access time observed in the landmark group (p < 0.05 and p < 0.01, respectively). Although there were a higher number of attempts, longer access time, and a more frequent complication rate in the landmark group, the success rate was found to be comparable between the two groups. CONCLUSION: The findings of this study indicate that internal jugular vein catheterization guided by real-time ultrasound results in a lower access time and a lower rate of immediate complications

Equilibrium and Kinetic Studies on Reactive Extraction of Pyruvic Acid with Trioctylamine in 1-Octanol

Interest in pyruvic acid has been growing due to the increase in its potential areas of use and its importance in metabolic reactions. These reasons along with the limitations on recovery have prompted researchers to consider novel recovery techniques. Reactive extraction has been proposed as a promising approach to the recovery of carboxylic acids. In this study, equilibrium and kinetic data were obtained for reactive extraction of pyruvic acid using trioctylamine (TOA) or Alamine 336 in 1-octanol or oleyl alcohol. The results showed that, without pH adjustment in the aqueous phase, and without the use of an extractant, 1-octanol extracted more pyruvic acid than oleyl alcohol with a distribution coefficient (K(D)) of 0.30. This trend remained the same when tertiary amines were used as an extractant. The K(D) values did not significantly differ with TOA or Alamine 336. The recovery of pyruvic acid was observed to increase as a function of TOA concentration and the stoichiometry of the reaction was mainly 1:1. As tertiary amines react only with undissociated acids, an increase in the initial pH of the aqueous phase lowered the KD values. When the pH was 4.0, the effect of TOA concentration on pyruvic acid extraction disappeared and for all concentration levels a distribution coefficient of 0.10 was obtained. Kinetic measurements showed that the reaction between pyruvic acid and TOA in 1-octanol is first order with respect to the two reactants with a rate constant of 0.94 L mol(-1) s(-1). The enhancement factor was calculated as 25

The effect of different solvents on the performance of zeolite-filled composite pervaporation membranes

The aim of this research is to study effect of different solvents on the membrane morphology and on the performance of zeolite-filled composite pervaporation membranes. PAN (polyacrylonitrile) was used as a base polymer and zeolite 13x (32 wt.%) was used as the filler. The solvents considered were DMF (dimethyl formamide), DMSO (dimethyl sulfoxide), DMAc (dimethyl acedamide) and THF (tetrahydrofuran). The cross-sectional morphology of manufactured membranes shows three layers: a zeolite-free polymer layer, a zeolite-filled polymer layer and a skin layer. However, at the same casting content (5.4% PAN, 2.6% zeolite 13x, 92 wt.% solvent) the ratio of the thickness of these layers to total membrane thickness varies with the solvent used. The most homogeneous zeolite distribution in the polymer network is obtained with solvent DMSO

Anticancer activity of linalool: comparative investigation of ultrastructural changes and apoptosis in breast cancer cells

Breast cancer is the most common cancer in women in the world. Many anticancer drugs are currently used clinically have been isolated from plant species or are based on such substances. Linalool is aromatic compounds from the monoterpene group. It is the main constituents of essential oils and show antiproliferative, antioxidant, and antiseptic properties. The aim of this study was to investigate the antiproliferativeand apoptotic, effects of linalool in MCF-7 and MDA-MB-231 human breast cancer cells. MCF-7 and MDA-MB-231 human breast cancer cells were treated with different concentrations of linalool (100, 200, 400, 600, 800, 1000 mu M) at 24 h and 48 h. MTT assay for cell proliferation and Annexin V assay for apoptosis was done. The morphology of breast cancer cells was investigated by light microscope and scanning electron microscope (SEM). The study show that linalool significantly induced apoptosis in all groups as dose and time-dependent (p < .05). Linalool has apoptotic and antiproliferative properties in a concentration and time-dependent manner in breast cancer cells. The cytotoxic effects of linalool on MCF-7 and MDA-MB-231 human breast cancer cells was found to be associated with apoptotic cell death. Linalool was more effective on MCF-7 human breast cancer cells in smaller amounts.Scientific Research Fund of Mugla Sitki Kocman University [17/061]This study was financially supported by a grant from Scientific Research Fund of Mugla Sitki Kocman University (Grant number: 17/061)

The Protective Role of Resveratrol on Diabetic Cardiomyopathy

13th International Congress of Update in Cardiology and Cardiovascular Surgery (UCCVS) -- MAR 23-26, 2017 -- Cesme, TURKEYWOS: 00040730920007

Intrathecal morphine in anesthesia for cesarean delivery: dose-response relationship for combinations of low-dose intrathecal morphine and spinal bupivacaine

Study objective: To evaluate the quality of analgesia and the severity of side effects of intrathecal morphine administered for a dose range of 0.0 to 0.4 mg for postcesarean analgesia with low-dose bupivacaine