Sedation Monitoring and Management during Percutaneous Endoscopic Lumbar Discectomy

Percutaneous endoscopic laser discectomy (PELD) is a painful intervention that requires deep sedation and analgesia. However, sedation should be light at some point because cooperation by the patient during the procedure is required for successful surgical treatment. Light sedation poses a problem for endotracheal intubation, while patients placed in the prone position during percutaneous endoscopic discectomy pose a problem for airway management. Therefore, under these conditions, sedation should be not deeper than required. Here we report the sedation management of three cases that underwent PELD, with a focus on deep and safe sedation that was monitored using bispectral index score and observer’s assessment of alertness/sedation score

Case Report Sedation Monitoring and Management during Percutaneous Endoscopic Lumbar Discectomy

Percutaneous endoscopic laser discectomy (PELD) is a painful intervention that requires deep sedation and analgesia. However, sedation should be light at some point because cooperation by the patient during the procedure is required for successful surgical treatment. Light sedation poses a problem for endotracheal intubation, while patients placed in the prone position during percutaneous endoscopic discectomy pose a problem for airway management. Therefore, under these conditions, sedation should be not deeper than required. Here we report the sedation management of three cases that underwent PELD, with a focus on deep and safe sedation that was monitored using bispectral index score and observer's assessment of alertness/sedation score

Primjena kometnog testa u procjeni oštećenja DNA nastalih zbog ishemijskoreperfuzijskih ozljeda u bolesnika podvrgnutih kirurškim zahvatima na koronarnim žilama

Ischaemia-reperfusion (I/R) injury is responsible for a number of conditions such as coronary bypass and myocardial infarction, and deaths. Oxygen-free radicals formed during I/R have been proposed as the leading causes of tissue injury, and they play an important role in I/R injury. I/R induces oxidative DNA damage (such as purinic and pyrimidinic base lesions). Comet assay is a suitable and sensitive method for early detection of low-level DNA damage. We used modified alkaline comet assay in peripheral blood lymphocytes and evaluated I/R-induced DNA damage in patients undergoing coronary artery bypass graft (CABG) operation (in vivo model for I/R). No statistically significant difference in DNA damage levels was found before surgery, after anaesthesia, ischemia, reperfusion, and surgery. However, blood lactate levels (assessed in parallel with the comet assay) increased after I/R and did not return to the baseline level. Our findings showed that I/R injury did not induce DNA damage, but increased the lactate levels. This finding suggests that there might be reversible and uncommon necrosis that did not refl ect on overall DNA base damage. Further studies are needed using this approach.Ishemijsko-reperfuzijska (I/R) ozljeda čest je uzročnik pobola i smrtnosti u slučajevima kao što su ugradnja koronarnih premosnica, infarkt miokarda i sl. Slobodni kisikovi radikali koji nastaju tijekom procesa ishemije i reperfuzije smatraju se jednim od glavnih uzročnika oštećenja tkiva i imaju važnu ulogu u I/R ozljedama. I/R ozljede izazivaju oksidativna oštećenja u DNA (primjerice oštećenja purinskih i pirimidinskih baza). Kometni test osjetljiva je metoda koja omogućuje utvrđivanje niskih razina primarnih oštećenja u molekuli DNA. U ovom smo istraživanju primjenom kometnog testa na bijelim krvnim stanicama procjenjivali razine oštećenja u DNA nastale zbog I/R ozljeda u bolesnika podvrgnutih ugradnji premosnice koronarne arterije (in vivo model za I/R). Rezultati istraživanja upućuju na to da nema značajnih razlika u razinama oštećenja DNA izmjerenim u uzorcima krvi uzimanima prije kirurškog zahvata, nakon anestezije te tijekom ishemije, reperfuzije i zahvata. Međutim, uočeno je da su nakon I/R ozljede porasle razine laktata u serumu koje se više nisu vratile na početne vrijednosti. Takve vrijednosti laktata u serumu upućuju na to da tijekom I/R nastupa neobična i reverzibilna nekroza koja se, međutim, ne odražava na stupanj oštećenja DNA. Za objašnjenje ovih zapažanja potrebna su daljnja istraživanja

Sedation Monitoring and Management during Percutaneous Endoscopic Lumbar Discectomy

Percutaneous endoscopic laser discectomy (PELD) is a painful intervention that requires deep sedation and analgesia. However, sedation should be light at some point because cooperation by the patient during the procedure is required for successful surgical treatment. Light sedation poses a problem for endotracheal intubation, while patients placed in the prone position during percutaneous endoscopic discectomy pose a problem for airway management. Therefore, under these conditions, sedation should be not deeper than required. Here we report the sedation management of three cases that underwent PELD, with a focus on deep and safe sedation that was monitored using bispectral index score and observer’s assessment of alertness/sedation score

Assessment of demographic, clinical and histopathological features of patients who underwent appendectomy due to a presumed diagnosis of acute appendicitis

BACKGROUND: To compare the clinical, biochemical, and histopathological features of patients who underwent appendectomy due to a presumed diagnosis of acute appendicitis (AAp)