Efectos del mantenimiento de varias anestesias sobre los niveles séricos de selenio, cobre, cinc y hierro y la capacidad antioxidante

ResumenJustificación y objetivosInvestigar los efectos del mantenimiento de sevoflurano, desflurano y propofol sobre los niveles séricos de selenio, cobre, cinc, hierro y malondialdehído, las medidas de glutatión peroxidasa y la capacidad antioxidante.MétodosFueron ubicados en 3 grupos 60 pacientes programados para cirugía unilateral de miembros inferiores, realizada con torniquete bajo anestesia general. Fueron recogidas muestras de sangre para determinar los niveles séricos basales de selenio, cobre, cinc, hierro, malondialdehído y glutatión peroxidasa. La anestesia fue inducida con 2-2,5mg/kg−1 de propofol, 1mg/kg−1 de lidocaína y 0,6mg/kg−1 de rocuronio. En el mantenimiento de la anestesia, bajo gas portador de 50% de O2 y 50% de N2O (4L/min−1), sevoflurano a 1CAM fue administrado al grupo S; y desflurano a 1CAM al grupo D y bajo gas portador en mezcla de 50% O2 y 50% aire (4L/min−1), 6mg/kg/h−1 de propofol y 1μg/kg/h−1 de fentanilo fueron administrados al grupo P. En el postoperatorio se recogieron de nuevo muestras de sangre.ResultadosSolamente en los grupos S y P los niveles de malondialdehído disminuyeron en las 48h del postoperatorio; los niveles de glutatión peroxidasa aumentaron en comparación con los valores basales. Los niveles de selenio disminuyeron en el grupo S y en el grupo P, los niveles de cinc disminuyeron en el grupo P, los de hierro disminuyeron en todos los grupos y no hubo alteración en los niveles de cobre en ningún grupo en el período postoperatorio.ConclusiónDe acuerdo con los marcadores de malondialdehído y glutatión peroxidasa, llegamos a la conclusión de que el mantenimiento de la anestesia general con propofol y sevoflurano activó el sistema antioxidante contra el estrés oxidativo y el uso de desflurano no tuvo efectos sobre el estrés oxidativo y el sistema antioxidante.AbstractBackground and objectivesIn this study, we aimed to investigate the effects of sevoflurane, desflurane and propofol maintenances on serum levels of selenium, copper, zinc, iron, malondialdehyde, and glutathion peroxidase measurements, and antioxidant capacity.Methods60 patients scheduled for unilateral lower extremity surgery which would be performed with tourniquet under general anesthesia were divided into three groups. Blood samples were collected to determine the baseline serum levels of selenium, copper, zinc, iron, malondialdehyde and glutathion peroxidase. Anesthesia was induced using 2-2.5mg/kg−1 propofol, 1mg/kg−1 lidocaine and 0.6mg/kg−1 rocuronium. In the maintenance of anesthesia, under carrier gas of 50:50% O2:N2O 4L/min−1, 1MAC sevoflorane was administered to group S and 1MAC desflurane to group D; and under carrier gas of 50:50% O2:air 4L/min−1 6mg/kg/h−1 propofol and 1μg/kg/h−1 fentanyl infusion were administered to group P. At postoperative blood specimens were collected again.ResultsIt was observed that only in group S and P, levels of malondialdehyde decreased at postoperative 48th hour; levels of glutathion peroxidase increased in comparison to the baseline values. Selenium levels decreased in group S and group P, zinc levels decreased in group P, and iron levels decreased in all three groups, and copper levels did not change in any groups in the postoperative period.ConclusionAccording to the markers of malondialdehyde and glutathion peroxidase, it was concluded that maintenance of general anesthesia using propofol and sevoflurane activated the antioxidant system against oxidative stress and using desflurane had no effects on oxidative stress and antioxidant system

Attitudes and Behaviors of Anesthesia Workers in Turkey Towards Drug Labeling: A Questionnaire Study

WOS: 000499973900006Introduction: Standard drug syringe labels can reduce drug errors. In this study, it was aimed to report the attitudes of anesthesia workers (AW) towards labeling, to emphasize the importance of drug labeling in drug errors and to contribute to safe anesthesia practices by raising awareness about standardization. Methods: The study was initiated after obtaining permission from the Zonguldak Bulent Ecevit University Clinical Research Ethics Committee. A confidential, self-reporting questionnaire was sent to each member of Turkish Anesthesiology and Reanimation Society and to technicians whose e-mail addresses were known. Results: A total of 189 people participated. Of all participants, 49.2% were aware of standard syringe label (SSL). While 67.3% of these participants stated that they used color-coded self-adhesive labels, 47% stated that they did not know which standards these labels met. AWs suggested that color-coded self-adhesive labels (92.9%), SSL for vials (97.3%) and pre-prepared syringes (87.8%) were effective in reducing drug administration errors (DAE). Of all participants, 89.9% stated that they did not know DAE and 84.7% stated that they read the label each time before administration. AWs stated that DAE could be prevented through standard labeling procedures (47%), attention (23%), education (21%) and producing the vials in different sizes and colors (9%). Conclusion: AWs stated that developing and standardizing the vial labels, scheduling trainings, paying care and attention were important in prevention of labeling-related errors

Effects of various anesthesia maintenance on serum levels of selenium, copper, zinc, iron and antioxidant capacity

WOS: 000348246300009PubMed: 25497750Background and objectives: In this study, we aimed to investigate the effects of sevoflurane, Desflurane; desflurane and propofol maintenances on serum levels of selenium, copper, zinc, iron, malondialdehyde, and glutathion peroxidase measurements, and antioxidant capacity. Methods: 60 patients scheduled for unilateral lower extremity surgery which would be performed with tourniquet under general anesthesia were divided into three groups. Blood samples Antioxidant capacity were collected to determine the baseline serum levels of selenium, copper, zinc, iron, malondialdehyde and glutathion peroxidase. Anesthesia was induced using 2-2.5 mg kg(-1) propofol, 1 mg kg(-1) lidocaine and 0.6 mg kg(-1) rocuronium. In the maintenance of anesthesia, under carrier gas of 50:50% O-2:N2O 4 L min(-1), 1 MAC sevoflorane was administered to Group S and 1 MAC desflurane to Group D; and under carrier gas of 50:50% O-2:air 4 L min(-1) 6 mg kg h(-1) propofol and 1 mu g kg h(-1) fentanyl infusion were administered to Group P. At postoperative blood specimens were collected again. Results: It was observed that only in Group S and P, levels of MDA decreased at postoperative 48th hour; levels of glutathion peroxidase increased in comparison to the baseline values. Selenium levels decreased in Group S and Group P, zinc levels decreased in Group P, and iron levels decreased in all three groups, and copper levels did not change in any groups in the postoperative period. Conclusion: According to the markers of malondialdehyde and glutathion peroxidase, it was concluded that maintenance of general anesthesia using propofol and sevoflurane activated the antioxidant system against oxidative stress and using desflurane had no effects on oxidative stress and antioxidant system. (C) 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.Bulent Ecevit University Scientific Researches Projects Coordination UnitBulent Ecevit UniversityThis study was supported by Bulent Ecevit University Scientific Researches Projects Coordination Unit

Comparison of the Effects of Oral Midazolam, Ketamine and Tramadol on Postoperative Agitation Related to Sevoflurane in Children

Aim: The aim of our study was to investigate the effects of oral midazolam, ketamine and tramadol, which have been administered as premedication in pediatric patients, on sedation quality, postoperative agitation and pain

Effects of various anesthesia maintenance on serum levels of selenium, copper, zinc, iron and antioxidant capacity

BACKGROUND AND OBJECTIVES: In this study, we aimed to investigate the effects of sevoflurane, desflurane and propofol maintenances on serum levels of selenium, copper, zinc, iron, malondialdehyde, and glutathion peroxidase measurements, and antioxidant capacity. METHODS: 60 patients scheduled for unilateral lower extremity surgery which would be performed with tourniquet under general anesthesia were divided into three groups. Blood samples were collected to determine the baseline serum levels of selenium, copper, zinc, iron, malondialdehyde and glutathion peroxidase. Anesthesia was induced using 2-2.5 mg kg-1 propofol, 1 mg kg-1 lidocaine and 0.6 mg kg-1 rocuronium. In the maintenance of anesthesia, under carrier gas of 50:50% O2:N2O 4 L min-1, 1 MAC sevoflorane was administered to Group S and 1 MAC desflurane to Group D; and under carrier gas of 50:50% O2:air 4 L min-1 6 mg kg h-1 propofol and 1 µg kg h-1 fentanyl infusion were administered to Group P. At postoperative blood specimens were collected again. RESULTS: It was observed that only in Group S and P, levels of MDA decreased at postoperative 48th hour; levels of glutathion peroxidase increased in comparison to the baseline values. Selenium levels decreased in Group S and Group P, zinc levels decreased in Group P, and iron levels decreased in all three groups, and copper levels did not change in any groups in the postoperative period. CONCLUSION: According to the markers of malondialdehyde and glutathion peroxidase, it was concluded that maintenance of general anesthesia using propofol and sevoflurane activated the antioxidant system against oxidative stress and using desflurane had no effects on oxidative stress and antioxidant system

The effect of gender on reversal of non-depolarizing block with Sugammadex

Sugammadex is a rapid and selective aminosteroid agent that has entered use recently. We aimed to research the effect of gender on reversal of non-depolarizing block with sugammadex. We designed a prospective study. The research included a total of 100 cases who underwent rhinoplasty operation administered general anaesthesia. Cases were divided according to gender as male (Group M) and female (Group F). At the end of the operation for patients with TOF value 25%, patients were given 2 mg kg-1 iv sugammadex. Duration from the rocuronium administration until the TOF value was zero(TOF0), the time from sugammadex administration until TOF reached from 25% to 90% was recorded (TOF25-90). The time from TOF90 to extubation was named the extubation duration. From the time the patients entered the PCU until Aldrete score was ≥9 was named the recovery duration and recorded. The time for the groups to TOF25-90 was 123.84 ± 38.03 s in Group M and 122.06 ± 30.461 s in Group F (p > 0.05). The extubation duration was 189.68 ± 41.37 s in Group M and 206.50 ± 45.99 in Group F (p = 0.316). The recovery time was 8.26 ± 14 min in Group M and 8.48 ± 14.23 min in Group F (p = 0.328). After the administration of sugammadex, there was no difference observed between the groups in terms of the TOF25-90 duration, recovery and extubation duration. As a result, conclusion was reached that gender did not affect rocuronium reversal with sugammadex. [Med-Science 2018; 7(2.000): 306-11

The Effects of Preoperative Acupuncture Needle and Capsicum Plaster Applications of Extra 1, Pericardium 6 and Large Intestine 4 Points on Preoperative Anxiety, Postoperative Nausea-Vomiting and Analgesic Consumption

WOS: 000272651300003Objective: The acupuncture points pericardium 6 (P 6), extra I (E 1), and large intestine 4 (Li 4) are known to reduce postoperative nausea and vomiting, and to provide sedation and analgesia, respectively. We investigated the effects of preoperative application of acupuncture needle or capsicum plaster on these points on preoperative anxiety, postoperative nausea and vomiting, and analgesic consumption. Material and Methods: Sixty cases undergoing laparoscopic gynecological operations were divided into four groups. The day before the operation, State Trait Anxiety Inventory (STAI) was given to all cases. The participants were divided into four groups regarding the preoperative application of the following: dry needle at points P 6, Li 4 and El in group 1; capsicum plaster application at the same points in group II; 0.07 mg kg(-1) midazolam im and plasebo plaster application at different non acupunctural points (sham) in group III and only placebo plaster usage at sham points in group IV. STAI was repeated immediately before the operation. After standard general anesthesia, tramadol was administered with postoperative patient controlled analgesia method. Postoperative visual pain score (VAS), analgesic consumption, and nausea and vomiting were recorded. Results: The decrease in the preoperative day 1 STAI scores compared to immediate preoperative scores in group I and group II was significantly higher than the decrease in group III (p < 0.05). Nausea and vomiting rates were lower in group I and II (p < 0.05). The postoperative analgesic consumption of group I and group IV were lower than that of group 11 and group III (p < 0.05). There was no significant difference between the study groups regarding VAS scores. Conclusion: Preoperative acupuncture needle and capsicum plaster application at P 6, El, and Li 4 points were found to be effective in reducing preoperative anxiety and postoperative nausea and vomiting, but thought to be non effective on postoperative analgesic consumption. Noninvasive capsicum plasters are concluded to be a good alternative method for needles that may cause side effects

The Effects of the Menstrual Cycle on the Hemodynamic Response to Laryngoscopy and Tracheal Intubation

WOS: 000280478400019PubMed: 20584874We designed this study to determine the effect of the menstrual cycle on the hemodynamic response to tracheal intubation (TI). Sixty-two ASA I women who were either in the follicular phase (group F, n = 31) or luteal phase (group L, n = 31) of their menstrual cycle were included in the study. Patients received propofol and rocuronium for intubation. Hemodynamic variables were recorded before administration of the IV anesthetic, as well as after TI. Rate pressure products were calculated. Groups were similar in terms of demographic data. Rate pressure products values at the first minute after TI were significantly increased in group L than were those in group F (P < 0.001). We conclude that the phase of the menstrual cycle is an important factor in the hemodynamic response to TI. (Anesth Analg 2010;111:362-5

Impact of the practising anesthesiologist team member on the laryngeal mask cuff pressures and adverse event rate

OBJECTIVE: We have planned to evaluate the laryngeal mask cuff pressures (LMcp) inflated by anesthesia workers of several seniority, without using manometer. METHODS: 180 patients scheduled to have short duration surgery with laryngeal mask were included in the study. Five anesthesia specialists (Group S), 10 residents (Group R) and 6 technicians (Group T) inflated the LMc; thereafter LMcp were measured with pressure manometer. Participants have repeated this practice in at least five different cases. LMcp higher than 60 cm H2O at the initial placement or intraoperative period were adjusted to normal range. Sore throat was questioned postoperatively. Groups were compared in terms of mean LMcp and occupational experience. RESULTS: At the settlement of LM, LMcp pressures within the normal range were determined in 26 (14.4%) cases. Mean LMcp after LM placement in Group S, R and T were 101.2 ± 14.0, 104.3 ± 20.5 cm H2O and 105.2 ± 18.4 cm H2O respectively (p > 0.05). Mean LMcp values in all measurement time periods within the groups were above the normal limit (60 cm H2O). When groups were compared in terms of LMcp, no difference has been found among pressure values. Occupational experience was 14.2 ± 3.9; 3.3 ± 1.1 and 6.6 ± 3.8 years for specialists, residents and technicians respectively and measured pressure values were not different in regard of occupational experience. Seven (3.9%) patients had sore throat at the 24th hour interview. CONCLUSION: Considering lower possibility of normal adjustment of LMcp and ineffectiveness of occupational experience to obtain normal pressure values, it is suitable that all anesthesia practitioners should adjust LMcp with manometer

The Effects of a Subhypnotic Dose of Ketamine on Neuromuscular Block Characteristics of Rocuronium and Intubation Quality

WOS: 000305320400015Objective: In this study, we aimed to examine the effects of a subhypnotic dose of ketamine on the neuromuscular block characteristics of rocuronium and intubation quality. Material and Methods: Sixty patients in ASA I-II risk group were included in the study. Group S received 5 mL of 0.9% saline and Group K received 0.5 mg.kg(-1) ketamine in 5 mL volume, one minute before induction. Both groups had anesthesia induction with a propofol dose of 2.5 mg.kg(-1) (Propofol 1%, Fresenius Kabi). This was considered as anesthesia start time. After 1 min, a control single twitch stimulus (0.1 Hz) was applied and recorded. All patients were given 0.6 mg.kg(-1) rocuronium (Esmeron (R) 50 mg.5 ml(-1) N.V. Organon, Oss, Holland) in 5 sec. When the single twitch response was depressed 100%, the patient was intubated and the full depression time (onset time) was noted. Anesthesia maintenance was achieved with O-2/N2O and sevoflurane. Following the intubation, the application of train-of - four (TOF) stimulation was started. When the TOF ratio reached to 20%, rocuronium was repeated at a dose of 0.2 mg.kg(-1). Clinical duration (T25), recovery index (T25-75) and spontaneous recovery time to TOF > 0.9 were recorded. Intubation conditions were assessed by using the scale of Fuchs-Buder. The additional drugs used during the operation and neuromuscular blocker amounts were recorded. The hemodynamic values of both groups were recorded throughout the study. Postoperative recovery times, visual analogue pain scores (VAS) and Ramsay sedation scores were also recorded. Results: The time for 100% depression of single twitch in Group K was shorter than that of Group S (p0.05), recovery times (p>0.05), VAS scores, Ramsay sedation scores or mean arterial pressure values. When the mean heart rate values of the groups were compared, all values of Group K were higher than those of Group S except control and 60th min values (p<0.001). Conclusion: According to our findings, ketamine in a subhypnotic dose shortens the onset time of rocuronium block and extends the clinical duration of first dose of rocuronium without improving the intubation quality