THE EFFECT OF PREOPERATIVE ANXIETY ON FETAL CORD BLOOD TUMOR NECROSIS FACTOR-ALPHA, INTERLEUKIN-6, AND NEONATAL OUTCOMES IN PREGNANT WOMEN

Backgrounds: In this study, we aimed to investigate the relationship in pregnant women who undergo elective cesarean section between the preoperative anxiety (POA) levels and neonatal results and TNF-alfa,IL-6 and IL-8 levels, the pro-inflammatory cytokines in cord blood. Subjects and methods: Sixty-six volunteer patients, aged 18 to 40, who underwent elective cesarean surgery were included in the study. Trait Anxiety Inventory (TAI) was evaluated at the anesthesia outpatient clinic and State Anxiety Inventory (SAI) was determined one hour before cesarean section. Plasma levels of TNF-alfa,IL-6 and IL-8 in the umbilical cord blood were determined using the ELISA method. Fetal cord blood gas, birth weight, and APGAR scores at the 1st and 5th minutes after birth were recorded. Results: The mean preoperative maternal SAI and TAI scores were 46,6+-10,9 and 41,4+-7,8, respectively. There was a significant correlation between POA and fetal birth weight and fetal cord blood TNF-alfa,IL-6 and IL-8 parameters. The inflammatory marker levels in the cord blood of fetuses in the high anxiety groups were significantly higher (p<0.001). Fetal birth weight was significantly lower in the high anxiety groups (p<0.05), whereas there was no significant difference in cord blood gas values. Conclusions: Our results show that an increase in the levels of TNF-alfa,IL-6, and IL-8 cytokines in fetal cord blood in pregnant women with high anxiety levels and this situation causes negative effects on the newborn

THE EFFECT OF PREOPERATIVE ANXIETY ON FETAL CORD BLOOD TUMOR NECROSIS FACTOR-ALPHA, INTERLEUKIN-6, AND NEONATAL OUTCOMES IN PREGNANT WOMEN

Backgrounds: In this study, we aimed to investigate the relationship in pregnant women who undergo elective cesarean section between the preoperative anxiety (POA) levels and neonatal results and TNF-alfa,IL-6 and IL-8 levels, the pro-inflammatory cytokines in cord blood. Subjects and methods: Sixty-six volunteer patients, aged 18 to 40, who underwent elective cesarean surgery were included in the study. Trait Anxiety Inventory (TAI) was evaluated at the anesthesia outpatient clinic and State Anxiety Inventory (SAI) was determined one hour before cesarean section. Plasma levels of TNF-alfa,IL-6 and IL-8 in the umbilical cord blood were determined using the ELISA method. Fetal cord blood gas, birth weight, and APGAR scores at the 1st and 5th minutes after birth were recorded. Results: The mean preoperative maternal SAI and TAI scores were 46,6+-10,9 and 41,4+-7,8, respectively. There was a significant correlation between POA and fetal birth weight and fetal cord blood TNF-alfa,IL-6 and IL-8 parameters. The inflammatory marker levels in the cord blood of fetuses in the high anxiety groups were significantly higher (p<0.001). Fetal birth weight was significantly lower in the high anxiety groups (p<0.05), whereas there was no significant difference in cord blood gas values. Conclusions: Our results show that an increase in the levels of TNF-alfa,IL-6, and IL-8 cytokines in fetal cord blood in pregnant women with high anxiety levels and this situation causes negative effects on the newborn

ANTINEPHROLITHIATIC ACTIVITY OF PERSEA AMERICANA (AVOCADO) AND VIBURNUM OPULUS (GUELDER ROSE) AGAINST ETHYLENE GLYCOL-INDUCED NEPHROLITHIASIS IN RATS

Background: Nephrolithiasis is a severe health problem causing morbidity. Chemolisis, extracorporeal shock wave lithotripsy (SWL), percutaneous nephrolithotomy (PNL), retrograde ureterorenoscopy (URS), and open and laparoscopic surgery are used for treatment with various success rates. Medical treatments with fewer complications were investigated thoroughly. Materials and Methods: In this study, we evaluated the effects of Persea americana (avocado) leaves and Viburnum opulus (guelder rose) fruits on nephrolithiasis in an animal model and used 42 rats. The groups received both low and high doses of Persea americana leaves and Viburnum opulus fruit ethanol extracts orally for 28 days. These two plants have been used for years in Turkey for their nephrolithiatic effect. Results: Avocado and guelder rose increased the urine volume and urine citrate levels, decreased urine cystine and oxalate levels, and lowered the crystal deposits in kidney tissue. Avocado and guelder rose also prevented oxidant damage and crystal formation in kidney tissue samples. Conclusion: The two plants that have been used for years for nephrolithiasis treatment in Turkey can safely be used for kidney stones

Effects of the menstrual cycle on injection pain due to rocuronium

WOS: 000325732900009PubMed: 23965205Study Objective: To investigate the effect of the menstrual cycle on rocuronium injection pain. Design: Prospective, randomized, double-blinded study. Setting: Academic medical center. Patients: 80 ASA physical status 1 and 2 women scheduled for elective surgery with general anesthesia. Measurements: Patients were divided into two groups according to their time in the menstrual cycle. Forty patients at days 8 to 12 of the menstrual cycle were considered to be at the follicular phase (Group F), and 40 patients at days 20 to 24 of the menstrual cycle were considered to be at the luteal phase (Group L).Withdrawal movements were recorded. Main Results: Overall frequency of withdrawal movements was significantly higher in Group L than Group F (P < 0.001). The mean withdrawal movement score was 1.77 +/- 0.76 in Group L and 0.52 +/- 0.67 in Group F. Conclusion: Menstrual cycle phases affect the severity of rocuronium injection pain. Women exhibit greater pain sensitivity from rocuronium injection in the luteal phase than the follicular phase. (c) 2013 Elsevier Inc. All rights reserved

Low-dose levobupivacaine plus fentanyl combination for spinal anesthesia in anorectal surgery

BACKGROUND: the aim of this study was to investigate the effects of spinal anesthesia using two different doses of fentanyl combined with low-dose levobupivacaine in anorectal surgery. METHODS: in this prospective, double-blind study, 52 American Society of Anaesthesiologists I-II patients scheduled for elective anorectal surgery were randomized into two groups. The patients in group I received intrathecal 2.5 mg hyperbaric levobupivacaine plus 12.5 µg fentanyl and in group II received intrathecal 2.5 mg hyperbaric levobupivacaine plus 25 µg fentanyl. All the patients remained in the seated position for 5 min after completion of the spinal anesthesia. Sensory block was evaluated with pin-prick test and motor block was evaluated with a modified Bromage scale. RESULTS: motor block was not observed in both of the groups. The sensory block was limited to the S2 level in group I, and S1 level in group II. None of the patients required additional analgesics during the operation. Time to two-segment regression was shorter in group I compared with group II (p < 0.01). One patient in group I and 5 patients in group II had pruritus. Hemodynamic parameters were stable during the operation in both of the groups. CONCLUSION: spinal saddle block using hyperbaric levobupivacaine with both 12.5 µg and 25 µg fentanyl provided good quality of anesthesia without motor block for anorectal surgery in the prone position

Efeito in vitro de Dexmedetomidina na Agregação Plaquetária

PubMed: 24565297[No abstract available

Efeito in vitro de dexmedetomidina na agregação plaquetária

JUSTIFICATIVA E OBJETIVOS: Dexmedetomidina é um &#945;2-agonista seletivo. Há 250-300 receptores &#945;2-adrenérgicos na superfície de cada uma das plaquetas humanas e a efedrina induz a agregação das plaquetas por ligação desses receptores. Este estudo foi desenvolvido para estudar a função plaquetária após incubação com concentrações terapêuticas de dexmedetomidina. MÉTODOS: O estudo foi conduzido com 18 homens saudáveis, não fumantes, com idades entre 25 e 35 anos. Porque o intervalo recomendado de concentração terapêutica de dexmedetomidina, obtido por infusão intravenosa, é de 0,4-1,2 ng.mL-1, as soluções de dexmedetomidina foram preparadas em três concentrações diferentes. Os valores calculados da solução de dexmedetomidina e do diluente sem dexmedetomidina (controle) foram adicionados a uma amostra de sangue. Assim, 0; 0,4; 0,8 e 1,2 ng.mL-1 de concentrações plasmáticas de dexmedetomidina foram obtidas. Cada concentração de dexmedetomidina foi incubada com sangue total a 37ºC durante 15 minutos. Em seguida, as amostras de sangue foram centrifugadas para preparar o plasma rico em plaquetas e o plasma pobre em plaquetas. O plasma rico em plaquetas foi diluído com o plasma pobre em plaquetas para gerar o teste de plasma rico em plaquetas com uma contagem final de plaquetas de 250 ± 50 x 10(9).L-1. RESULTADOS: As amplitudes e os declives da agregação plaquetária foram estatisticamente semelhantes entre todos os grupos nos testes de agregação feitos com ADP, colágeno ou adrenalina. CONCLUSÃO:As concentrações terapêuticas de dexmedetomidina não tiveram efeito in vitro nas funções plaquetárias de indivíduos saudáveis

The Postoperative Analgesic Efficacy of Intraperitoneal Bupivacaine Compared with Levobupivacaine in Laparoscopic Cholecystectomy

WOS: 000339415200004PubMed: 25102706Background : The aim of this randomized controlled study was to compare the postoperative analgesic efficacy of intraperitoneal bupivacaine versus levobupivacaine in patients undergoing laparoscopic cholecystectomy. Methods : We randomly divided 90 patients undergoing elective laparoscopic cholecystectomy into 3 groups. A dose of 0.125% bupivacaine (Group B) 80 ml or 0.125% levobupivacaine (Group L) 80 ml or 0.09% NaCl (Group P) 80 ml was instilled intraperitoneally at the end of the procedure, before removal of the trocars. All patients had a standard anesthetic. Tramadol was administered intravenously via a patient controlled analgesia pump as a rescue analgesic in all patients. Postoperative pain scores were assessed at 30 minutes, 1, 2, 4, 6,12 and 24 hours after surgery by using a visual analog scale. The primary end point of this study was to compare tramadol consumption of the three groups at the postoperative 24 h. Total tramadol consumption, first analgesic requirement time and adverse effects were recorded. Results : Group B experienced significantly less pain (P < 0.01) than the placebo group at 6 h, 12 h and 24 h postoperatively during rest. Group L registered significantly lower visual analog scale scores (p < 0.01) than the placebo group at 12 h during rest. During movement, visual analog scale pain scores were lower in group B than Group P (P < 0.01). Additionally, total tramadol consumption was significantly lower in Group B than the other groups. First analgesic requirement time was shorter in the placebo group compared with group B and group L (P < 0.05). There was no significant difference between the groups with respect to right shoulder pain, total nausea and vomiting. Conclusion : Intraperitoneal instillation of bupivacaine 0.125% 80 ml (100 mg) is more effective than levobupivacaine 0.125% 80 ml (100 mg) in reducing the postoperative pain after laparoscopic cholecystectomy

In Vitro Effect of Dexmedetomidine on Platelet Aggregation

Background and objectives: : Dexmedetomidine is a selective α2-agonist. There are 250-300 α2- adrenoceptor on the surface of each human platelet and ephedrine induces platelet aggregation by binding these receptors. This study was designed to study platelet function after incubation with therapeutic concentrations of dexmedetomidine. Methods: The study was carried out on 18 healthy, non-smoking males, ages ranging 25 to 35 years old. Because of the recommended therapeutic concentration range of dexmedetomidine obtained by intravenous infusion is 0.4-1.2 ng.mL-1, dexmedetomidine solutions were prepared in three different concentrations. The calculated value of dexmedetomidine solution and diluent without dexmedetomidine as control were added to the blood sample. Thus, we obtained 0, 0.4, 0.8 and 1.2 ng.mL-1 dexmedetomidine concentrations of plasma. Each concentration of dexmedetomidine was incubated with whole blood at 37 °C during 15 minutes. Then blood samples were centrifugated to prepare platelet-rich plasma and platelet-poor plasma. The platelet-rich plasma was diluted with the platelet-poor plasma to yield test platelet-rich plasma with a final platelet count of 250 ± 50 X 109.L-1. Results: The platelet aggregation amplitudes and slopes were statistically similar among all groups by the aggregation test, which were performed with ADP, collagen or epinephrine. Conclusion: Therapeutic concentrations of dexmedetomidine had no effect on the platelet functions in healthy individuals in vitro. Keywords: Dexmedetomidine, In Vitro, Platelet aggregatio

Efficacy Of Prophylactic Ketamine In Preventing Postoperative Shivering

Background. Treatment with ketamine and pethidine is effective in postoperative shivering. The aim of this study was to compare the efficacy of low-dose prophylactic ketamine with that of pethidine or placebo in preventing postoperative shivering. Methods. A prospective randomized double-blind study involved 90 ASA I and II patients undergoing general anaesthesia. Patients were randomly allocated to receive normal saline (Group S, n=30), pethidine 20 mg (Group P, n=30) or ketamine 0.5 mg kg(-1) (Group K, n=30) intravenously 20 min before completion of surgery. The anaesthesia was induced with propofol 2 mg kg(-1), fentanyl 1 mu g kg(-1) and vecuronium 0.1 mg kg(-1). It was maintained with sevoflurane 2-4% and nitrous oxide 60% in oxygen. Tympanic temperature was measured immediately after induction of anaesthesia, 30 min after induction and before administration of the study drug. An investigator, blinded to the treatment group, graded postoperative shivering using a four-point scale and postoperative pain using a visual analogue scale (VAS) ranging between 0 and 10. Results. The three groups did not differ significantly regarding patient characteristics. The number of patients shivering on arrival in the recovery room, and at 10 and 20 min after operation were significantly less in Groups P and K than in Group S. The time to first analgesic requirement in Group S was shorter than in either Group K or Group P (P < 0.005). There was no difference between the three groups regarding VAS pain scores. Conclusion. Prophylactic low-dose ketamine was found to be effective in preventing postoperative shivering.WoSScopu