The effects of sevoflurane and isoflurane on recovery, mental and psychomotor functions in outpatient anaesthesia [Sevofluran ve isofluranin gunubirlik (outpatient) anestezi uygulamalarinda derlenme ile mental ve psikomotor fonksiyonlar uzerine etkileri]

In our study, we aimed to compare the effect of sevoflurane and isoflurane on postoperative recovery time, mental and psychomotor functions and pain relief in fourty adult patients (ASA I-II) undergoing for ambulatory (out-patient) surgery. The patients were divided into two groups, randomly. All patients were premedicated by diazem (10 mg IM) and atropin (0.5 mg IM). Anaesthesia induction was obtained with thiopentone (5 mg/kg) and vecuronium (0.1 mg/kg) administrated in patient who needed endotracheal entubation or muscle relaxation. Anaesthesia was maintained with sevoflurane (1.0-2.5%) and N2O (66%) in oxygen in group I and with isoflurane (0.5-1.5%) and N2O (66%) in oxygen in group II. Systolic arterial pressure (SAP), diastolic arterial pressure (DAP), peripheral O2 saturation (SpO2) and ECG were observed before induction, after induction and intubation, before, after extubation and at postoperative 5., 10., 15., 20., 25., 30. minutes. However, PAR scala was recorded following extubation and postoperative 5., 10., 15., 20., 25., 30., 40., 50., 60., 75. and 90. minutes. SCS (Short Cognitive Scale) and VAS (Visual Analog Scale) were recorded at postoperative 5., 10., 15., 20., 25., 30., 40., 50., 60., 75. and 90. minutes. Eight and up values was accepted reliable for PAR. There were not found statistically significance between groups in SAP, DAP, HR, and SpO2 values (p>0.05). PAR value was statistically significance higher in group I than group II at 10. minutes (p<0.05). There were not found significance at the another times (p>0.05). Eight and up values for PAR were much lower in group I (p<0.05). There were not found statistically significance between groups in SCS and VAS values (p>0.05). Finally sevoflurane has shorter postanaesthetic recovery time than isoflurane. However sevoflurane and isoflurane can be used easily for ambulatory (out-patient) surgery and does not show any difference on recovery regarding mental and psychomotor function

Reproducibility of wrist home blood pressure measurement with position sensor and automatic data storage

<p>Abstract</p> <p>Background</p> <p>Wrist blood pressure (BP) devices have physiological limits with regards to accuracy, therefore they were not preferred for home BP monitoring. However some wrist devices have been successfully validated using etablished validation protocols. Therefore this study assessed the reproducibility of wrist home BP measurement with position sensor and automatic data storage.</p> <p>Methods</p> <p>To compare the reproducibility of three different(BP) measurement methods: 1) office BP, 2) home BP (Omron wrist device HEM- 637 IT with position sensor), 3) 24-hour ambulatory BP(24-h ABPM) (ABPM-04, Meditech, Hun)conventional sphygmomanometric office BP was measured on study days 1 and 7, 24-h ABPM on study days 7 and 14 and home BP between study days 1 and 7 and between study days 8 and 14 in 69 hypertensive and 28 normotensive subjects. The correlation coeffcient of each BP measurement method with echocardiographic left ventricular mass index was analyzed. The schedule of home readings was performed according to recently published European Society of Hypertension (ESH)- guidelines.</p> <p>Results</p> <p>The reproducibility of home BP measurement analyzed by the standard deviation as well as the squared differeces of mean individual differences between the respective BP measurements was significantly higher than the reproducibility of office BP (p < 0.001 for systolic and diastolic BP) and the reproducibility of 24-h ABPM (p < 0.001 systolic BP, p = 0.127 diastolic BP). The reproducibility of systolic and diastolic office versus 24-h ABPM was not significantly different (p = 0.80 systolic BP, p = 0.1 diastolic BP). The correlation coefficient of 24-h ABMP (r = 0.52) with left ventricular mass index was significantly higher than with office BP (r = 0.31). The difference between 24-h ABPM and home BP (r = 0.46) was not significant.</p> <p>Conclusion</p> <p>The short-term reproducibility of home BP measurement with the Omron HEM-637 IT wrist device was superior to the reproducibility of office BP and 24- h ABPM measurement. Furthermore, home BP with the wrist device showed similar correlations to targed organ damage as recently reported for upper arm devices. Although wrist devices have to be used cautious and with defined limitations, the use of validated devices with position sensor according to recently recommended measurement schedules might have the potential to be used for therapy monitoring.</p