Comparison of the maternal and neonatal effects of bupivacaine plus fentanyl and ropivacaine plus fentanyl during cesarean delivery

Purpose: The aim of the present study was to compare the anesthetic efficacy, and fetal and maternal effects of 7.5 mg (1 ml) intrathecal 0.75% hyperbaric ropivacaine + 25 ìg (0.5 ml) fentanyl versus 5 mg (l ml) intrathecal 0.5% hyperbaric bupivacaine + 25 ìg (0.5 ml) fentanyl in elective cesarean delivery.Materials and Methods: The study included 40 ASA I–II cases scheduled for cesarean delivery that were randomized into two groups of 20 cases each. Cases in the RF group were administered 0.75% hyperbaric ropivacaine + 25 ìg (0.5 ml) fentanyl and those in the BF group were administered 5 mg (l ml) hyperbaric bupivacaine + 25 ìg (0.5 ml)fentanyl into the spinal space. The time until spinal anesthesia in the T4 dermatome, overall duration of analgesia, hemodynamic parameters, Apgar score of newborns at 1–5 min, fetal blood gas values (pH, PO2, PCO2, HCO3., and BE), maternal side effects, the degree of motor block, maternal need for ephedrine, objective pain scale score, and patient satisfaction were recorded in each group.Results: There were no significant differences between the groups in terms of the parameters evaluated (P > 0.05).Conclusion: In elective cesarean delivery, the combinations of bupivacaine + fentanyl or ropivacaine + fentanyl exhibited similar anesthetic efficacy, and fetal and maternal effects.Key words: Bupivacaine, cesarean, opioid, ropivacain

Changes in substrate utilization rates during 40 min of walking within the Fatmax range

WOS: 000489766000010PubMed ID: 31560234Background and aims: The aim of this study was to evaluate changes in fat oxidation rate during 40 min of continuous exercise and identify the intensity at the highest fat oxidation rate (Fatmax). Methods: A total of 14 sedentary males with age, body height, weight, and BMI averages of 29.3 +/- 0.7 years, 178.3 +/- 1.7 cm, 81.1 +/- 3.9 kg, and 25.4 +/- 0.9 kg/m(2), respectively, were included in the study. Fatmax was determined using an indirect calorimeter with an incremental treadmill walking test at least after 12 h of fasting. On a separate day, at least after 12 h of fasting, the participants walked for 40 min within their predetermined individual Fatmax heart rate and speed ranges. Results: The initial fat oxidation rate was not sustained within the first 16 min of exercise and was reduced; however, carbohydrate oxidation reached a stable level after nearly 10 min. Conclusions: In sedentary individuals, during low-intensity physical activity, fat oxidation rates may not be sustainable as expected from Fatmax testing. Therefore, when exercise is prescribed, one should consider that the fat oxidation rate might decrease in sedentary overweight individuals

An evaluation of the effects of perioperatively administered fluids on ischemia/reperfusion injury.

To investigate the effects of normal saline (0.9% NaCl) and 6% Hydroxyethyl Starch 130/0.4(HES) solution on Ischemia/Reperfusion (I/R) injury in patients undergoing knee arthroscopy operations with spinal anesthesia using a tourniquet

The analgesic effect of diclofenac sodium administered via the epidural route in an experimental visceral pain model

Purpose: The aim of this study was to investigate the characteristics of the analgesic effect of diclofenac sodium injected epidurally in single or repeated doses and whether tolerance develops in long‑term use.Materials and Methods: A total of 30 rats were included in the study. The rats were anesthetized using intraperitoneal ketamine hydrochloride and an epidural catheter (EC) was inserted at the level of 13th dorsal thoraco‑lumbar vertebrae (T13). Eleven rats were excluded from the study. The remaining 19 rats were randomly divided into three groups; Group Control (Group C) (n = 6) received 20 μL normal saline solution (NS) via EC for 10 days; Group Single Dose (Group SD) (n = 6) received 20 μL NS for 9 days and 6 μg diclofenac via EC on 10th day; Group Ten Doses (Group TDs) (n = 7) received 6 μg diclofenac via EC in 20 μL NS for 10 days. On the 10th day, 30 min after epidural diclofenac sodium, 300 mg/kg of 3% acetic acid was injected via intraperitoneal route, and the rats were observed for 30 min and number of writhing reflex (WR) was recorded.Results: The values of total number of Writhing Reflex (WRT) and Writhing reflex per minute(WR/min) were found to be significantly higher in Group C compared with Groups SD and TD (P = 0.009).Conclusion: Single and repeated doses of diclofenac sodium via epidural route have an analgesic effect in a visceral pain model in rats without developing tolerance.Keywords: Diclofenac sodium, epidural administration, visceral pai

Anaesthesia in a patient with severe ischemic heart disease: Case report [Agir i·skemik kalp hastasina anestezik yaklaşimimiz]

We describe our experience of thorocal epidural anesthesia (TEA) in combination with general anesthesia in a male patient undergoing operation due to adenocarcinoma of the stomach. The patient 65 years old had a coronary angiography revealing that LAD 100%, 1.diagonal 98%, 1. septal 100% and circumflex 100% were occluded. After obtaining written informed consent, he has been taken to the operation room for monitorization. In the sitting position, epidural catheterisation was performed through T7-8 interspace. 200 mg 2% prilocain and 25 mg 5% bupivacain in a total volume of 15 ml were injected via the catheter. Anesthesia was induced with 2 mg/kg lidocain, 2 microgram/kg fentanyl, 2 mg/kg propofol and 0,1 mg/kg vecuronium. Maintanance was provided by 0.5% isoflurane in 50% O2 and N2O mixture. We observed no complication during pertoperative period. The patient has been discharged with coronary artery bypass grafting (CABG) suggestion. Tea in combination with general anesthesia was performed to decrease anesthetic and surgical risks. We aimed not only to increase O2 delivery and decrease of consumption tea by coronary vasodilation due to sympathetic blockage, but also decrease autonomic and endocrine response, obtain a hemodynamic stability and succeed postoperative analgesia. Copyright © 2010 by Türkiye Klinikleri

The analgesic effect of diclofenac sodium administered via the epidural route in an experimental visceral pain model.

The aim of this study was to investigate the characteristics of the analgesic effect of diclofenac sodium injected epidurally in single or repeated doses and whether tolerance develops in long-term use

The case of a cyst hydatid localized within the interatrial septum

The ratio of cardiac involvement of Echinoccocus granulosus is 0.02-2% and although seen rarely. involvement of the interatrial septum has also been reported in the published literature. The present case was a 19-year-old male University student admitted to hospital with complaints of headache and dizziness. Computerized tomography of the cranium revealed a cystic mass located at the frontal region and enucleation of the cyst was performed during surgery. A cystic lesion 5 x 4 cm in size was detected within the interatrial septum on two-dimensional transthoracic echocardiography during the postoperative period and the patient was referred to our clinic. Open heart surgery was performed and a hydatid cyst that involved the interatrial septum was enucleated. The cyst wall was sutured to the interatrial septum. No complications developed during the postoperative period. The patient was discharged oil the fifth day of hospitalization and medical therapy was started with albendazole

An evaluation of the effects of perioperatively administered fluids on ischemia/reperfusion injury

Objective: To investigate the effects of normal saline (0.9\% NaCl) and 6\% Hydroxyethyl Starch 130/0.4(HES) solution on Ischemia/Reperfusion (I/R) injury in patients undergoing knee arthroscopy operations with spinal anesthesia using a tourniquet. Methods: The study comprised 48 ASA I-II patients undergoing knee arthroscopy with spinal anesthesia using a tourniquet. The patients were randomised into two groups and after standard monitoring two venous lines were introduced to obtain blood samples and to give intravenous therapy. In the control group (Group A) (n=21) 0.9\% NaCl, 10 ml/kg/hours and in the study group (Group B) (n= 19) 6\% Hydroxyethyl Starch 130/0.4, 10 ml/kg/hours infusion were administered. Spinal anesthesia was applied with 12.5 mg hyperbaric bupivacaine to all patients. The tourniquet was applied and the operation was started when the sensorial block level reached T10 dermatome. Blood xanthine oxidase (XO) and malondialdehyde (MDA) levels as an indicator of ischemia and reperfusion injury were measured in samples before fluid infusion (t1), before tourniquet application (t2), 1 minute before tourniquet release (t3), and at 5 (t4) and 15 (t5) minutes after tourniquet release. Results: No difference was observed between the two groups in respect of demographic parameters, the highest block level, duration before tourniquet application and tourniquet duration (p>0.05). The MDA level after tourniquet application and 15 minutes after tourniquet release was lower in Group B (p0.05). Conclusion: In this study 6\% Hydroxyethyl Starch 130/0.4 solution reduced MDA level which is an indicator of lipid peroxidation. 6\% Hydroxyethyl Starch 130/0.4 solution may be beneficial for Ischemia/reperfusion injuries