Comparison between magnesium sulfate and dexmedetomidine in controlled hypotension during functional endoscopic sinus surgery

AbstractBackground and objectivesIt is crucial to decrease bleeding during functional endoscopic sinus surgery. Our primary goal was to investigate the effects of magnesium sulfate and dexmedetomidine used for controlled hypotension on the visibility of the surgical site.Methods60 patients aged between 18 and 65 years were enrolled. In the magnesium sulfate group (Group M), patients were administered 40mg/kg magnesium sulfate in 100mL saline solution over 10min as the intravenous loading dose 10min before induction, with a subsequent 10–15μg/kg/h infusion during surgery. In the dexmedetomidine group (Group D), patients were administered 1μg/kg dexmedetomidine in 100mL saline solution as the loading dose 10min before surgery and 0.5–1μg/kg/h dexmedetomidine during surgery. Deliberate hypotension was defined as a mean arterial pressure of 60–70mmHg.ResultsBleeding score was significantly decreased in Group D (p=0.002). Mean arterial pressure values were significantly decreased in Group D compared to that in Group M, except for the initial stage, after induction and 5min after intubation (p<0.05). The number of patients who required nitroglycerine was significantly lower in Group D (p=0.01) and surgeon satisfaction was significantly increased in the same group (p=0.001). Aldrete recovery score ≥9 duration was significantly shorter in Group D (p=0.001). There was no difference between the two groups in terms of recovery room verbal numerical rating scale.ConclusionsDexmedetomidine can provide more effective controlled hypotension and thus contribute to improved visibility of the surgical site

Worker deaths: A regional autopsy study

Amaç: Uluslararası Çalışma Örgütü’ne göre her 15 saniyede bir 153 işçi iş kazası geçirmekte ve bir işçi iş kazaları veya hastalıklar nedeniyle ölmektedir. Dünyada her gün 6.300 insan iş kazaları veya işle ilişkili hastalıklar nedeniyle ölmektedir. Yöntem: Adli Tıp Kurumu Trabzon Grup Başkanlığı Morg İhtisas Dairesi’nde, 2011-2015 yılları arasında otopsisi yapılan, ölüm nedeni iş kazasına bağlanan olguların adli tahkikat evrakları ve otopsi raporları geriye dönük olarak incelendi. Bulgular: Toplam 112 işçi ölümünden 111’inin (%99,1) erkek, 1’inin (%0,9) kadın olduğu tespit edildi. Yaşları 18 ile 64 yıl arasında değişmekteydi. Olguların iş kollarına göre dağılımı incelendiğinde 61 (%54,5) olgunun inşaat sektöründe ve 12 (%10,7) olgunun enerji sektöründe çalıştığı tespit edildi. İş kazalarının 34 (%30,4) olguda yüksekten düşme, 19 (%17) olguda elektrik çarpması nedeniyle gerçekleştiği belirlendi. Yapılan otopsilerde 44 (%39,3) olguda kafatası kemik kırıkları, 22 (%19,6) olguda göğüs kafesi kırıkları vardı. Histopatolojik incelemelerde, 13 (%11,6) olguda kalp-damar patolojileri ve 20 (%17,9) olguda akciğerlerde ödem ve kanama bulundu. Sonuç: Ulusal iş kazası istatistikleriyle de uyumlu olarak, bu çalışmanın sonuçlarına göre, ilk sırada inşaat sektörü bulunmaktadır. Ölüm nedeni olarak ise yüksekten düşmeye bağlı genel beden travmaları, elektrik çarpmaları ve iş makinesi kazaları öne çıkmaktadır.Objective: According to the International Labor Organization, 153 workers are injured and one worker dies because of occupational accidents or diseases every 15 seconds. Every day, 6,300 people die due to occupational accidents or work-related diseases in the world. Methods: Forensic investigation documents and autopsy reports of patients who were autopsied between 2011 and 2015 at the Forensic Medicine Department of Morgue Specialization in Trabzon Group Presidency and whose causes of death were related to occupational accidents were examined retrospectively. Results: It was determined that 111 (99.1%) were male and 1 (0.9%) were female from a total of 112 worker deaths. Their ages ranged between 18 and 64 years. When the distribution of cases by business types was analyzed, it was determined that 61 (54.5%) cases worked in the construction sector and 12 (10.7%) in the energy sector. It was determined that work accidents occurred due to falling from height in 34 (30.4%) cases and electric shock in 19 (17%) cases. There were skull bone fractures in 44 (39.3%) cases and rib cage fractures in 22 (19.6%) cases during autopsies. In histopathological examinations, there were cardiovascular pathologies in 13 (11.6%) cases, edema and bleeding in the lungs in 20 (17.9%) cases. Conclusion: According to the results of this study, construction sector took place on the top, which is consistent with the national work accident statistics. As a cause of death, general body traumas due to falling from high, electric shocks and work machine accidents come to the fore