The effects of total intravenous anesthesia and inhalational anesthesia on intra-abdominal pressure in the supine prone positions

Amaç: Sırtüstü ve yüzüstü pozisyonları verilerek ameliyat edilen olgularda, total intravenöz anestezi ve inhalasyonda sevofluran anestezisinin intraabdominal basınç, kardiyovasküler ve solunum sistemlerine etkileri karşılaştırıldı. Çalışma Planı: Çalışmaya, lomber diskektomi ameliyatı geçirecek ASA I-II 30 olgu (17 erkek, 13 kadın; ort. yaş 50; dağılım 35-70) total intravenöz anestezi (grup I, n=15) ve sevofluran anestezisi (grup II, n=15) uygulanmak üzere rastgele iki gruba ayrıldı. Grup I’de, intravenöz olarak uygulanan alfentanil ve propofol ile sağlanan indüksiyondan sonra entübasyon atrakuryum ile gerçekleştirildi. Anestezinin idamesinde ise alfentanil ve 10 dakikalık sürelerle azalan dozlarda propofol infüzyon şeklinde kullanıldı. Grup II’de, intravenöz propofol ile sağlanan indüksiyondan sonra atrakuryum ile entübasyon gerçekleştirildi. Anestezi sürekliliği sevofluran ile sağlandı. Olguların sırtüstü pozisyonda anestezi indüksiyonundan önce ve hemen sonra; yüzüstü pozisyonuna çevrildikten hemen sonra, ameliyat boyunca her 30 dakikada bir ve sırtüstü pozisyonda ekstübasyondan hemen sonra intraabdominal basınç, arter basıncı, kalp atım hızı, periferik oksijen satürasyonu, endtidal CO2 basıncı ölçülerek kaydedildi. Bulgular: İki grup arasında bütün ölçüm zamanlarında, intraabdominal basınç, hemodinamik ve solunum parametre değerleri arasında anlamlı farklılık bulunmadı. Sonuç: Her iki pozisyonda uygulanan total intravenöz anestezi ve sevofluran anestezisinin, intraabdominal basınç ile hemodinamik ve solunum parametrelerinde değişiklik oluşturmadığı belirlendi.Objectives: We compared the effects of total intravenous anesthesia and inhalational anesthesia with sevoflurane on intra-abdominal pressure and cardiovascular and respiratory systems in patients undergoing surgery in the supine and prone positions. Study Design: Thirty ASA I-II patients (17 males, 13 females; mean age 50 years; range 35 to 70 years) undergoing elective lumbar discectomy were randomly assigned to total intravenous anesthesia (group I, n=15) and inhalational anesthesia with sevoflurane (group II, n=15). In group I, after anesthesia induction with intravenous alfentanil and propofol, entubation was performed with atracurium. Anesthesia was maintained with alfentanil and decreasing doses of propofol. In group II, induction was obtained with intravenous propofol, entubation with atracurium, and maintenance with sevoflurane. Intra-abdominal pressure, arterial pressures, heart rate, peripheral oxygen saturation, and endtidal CO2 were monitored and recorded in the supine position before and after anesthesia induction, immediately after turning to the prone position, every 30 minutes throughout the operation, and immediately after extubation in the supine position. Results: At all times of monitoring, no significant differences were found between the two groups with respect to intraabdominal pressure, hemodynamic and respiratory parameters. Conclusion: Total intravenous anesthesia and sevoflurane anesthesia do not appear to affect intra-abdominal pressure, hemodynamic and respiratory parameters in both positions

Comparison of recovery criteria following anaesthesia with sevoflurane and isoflurane in geriatric patients

Amaç: Bu çalışmada, geriyatrik hastalarda volatil anesteziklerden sevofluran ve isofluranın derlenme kriterleri üzerine etkileri karşılaştırıldı. Çalışma Planı: Elektif ürolojik ve jinekolojik cerrahi girişim planlanan ASA I-II grubundan 65 yaş ve üzeri 40 hasta rastgele eşit sayıda iki gruba ayrıldı. Tüm olguların premedikasyonu intramusküler 0.06 mgkg-1 midazolam, anestezi indüksiyonu intravenöz 1.5 mgkg-1 propofol, 0.6 mgkg-1 atrakuryum besilat ve 500 ?g alfentanil ile gerçekleştirildi. Anestezi idamesi grup I’de 1 MAC isofluran, grup II’de 1 MAC sevofluran ve gerektikçe intravenöz 0.1 mgkg-1 atrakurium ile sürdürüldü. Ameliyat sonunda her iki grupta da derlenme kriterleri olarak belirlenen spontan göz açma, ekstübasyon, sözel yanıt ve oryantasyon süreleri kaydedildi. Bulgular: Sevofluran grubunda, isofluran grubuna göre spontan göz açma (p=0.0002), ekstübasyon (p=0.0002), sözel yanıt (p=0.0001) ve oryantasyon (p=0.0001) süreleri anlamlı derecede kısa bulundu. Sonuç: Geriyatrik olgularda sevofluranın derlenme kriterleri açısından isoflurana göre daha avantajlı olduğu kanısına varıldı.Objectives: The aim of this study was to compare the effects of volatile anesthetics, sevoflurane and isoflurane, on recovery criteria in geriatric patients. Study Design: Forty ASA I-II patients at the age of 65 years or above, who were planned for elective urological or gynecological operation were randomized to two groups equal in number. Each group received 0.06 mgkg-1 intramuscular midazolam for premedication, and intravenous 1.5 mgkg-1 propofol, 0.6 mgkg-1 atracurium besylate, and 500 µg alfentanil for induction. Anesthesia was maintained with approximately 1 MAC isoflurane in group I, and 1 MAC sevoflurane in group II, and, when necessary, intravenous 0.1 mgkg-1 atracurium. Recovery criteria included spontaneous eye opening, extubation, verbal response, and orientation times at the end of operation. Results: Compared to the isoflurane group, durations of spontaneous eye opening (p=0.0002), extubation (p=0.0002), verbal response (p=0.0001), and orientation (p=0.0001) were significantly shorter in the sevoflurane group. Conclusion: We concluded that sevoflurane anesthesia is more advantegous over isoflurane in geriatric patients

Effect of Preoperative Anxiety on Depth of Anaesthesia and In Vitro Fertilization Success

Objective:Infertility anxiety may have a harmful effect on embryo quality and fertilization during in vitro fertilization (IVF). Monitoring brain function gives real-time information about the depth of anaesthesia of a patient. This study examined the effect of preoperative anxiety on the depth of anaesthesia and IVF success.Methods:One hundred thirty-one patients who had undergone oocyte retrieval were divided into two groups according to the Beck Anxiety Inventory (BAI): the low-anxious Group L (n = 71) and high-anxious Group H (n = 60). Hemodynamic stability, intraoperative total propofol and fentanyl consumption, good quality embryo (GQE) rate, and fertilization rate were recorded.Results:Fertilization and GQE rates were not significant between groups L and H. Total propofol consumption was significantly higher in group H than in group L. Heart rate (HR) preoperatively and postoperatively and systolic arterial pressure (SAP) preoperatively and diastolic arterial pressure (DAP) postoperatively were significantly increased in group H than in group L. The time for the modified Aldrete score to reach 9 (MAS 9) in group H was significantly higher than that in group L. The effect of variables that were found significantly in the univariate analysis (Propofol, HRpreop, HRpostop, SAPpreop, DAPpostop, and MAS 9) on BAI score.Conclusion:Total propofol consumption was higher in patients with high anxiety levels, but it did not have a negative effect on IVF success