Comparison of the Proseal, Supreme, and I-Gel SAD in Gynecological Laparoscopic Surgeries

We compared proseal, supreme, and i-gel supraglottic airway devices in terms of oropharyngeal leak pressures and airway morbidities in gynecological laparoscopic surgeries. One hundred and five patients undergoing elective surgery were subjected to general anesthesia after which they were randomly distributed into three groups. Although the oropharyngeal leak pressure was lower in the i-gel group initially (mean ± standard deviation; 23.9 ± 2.4, 24.9 ± 2.9, and 20.9 ± 3.5, resp.), it was higher than the proseal group and supreme group at 30 min of surgery after the trendelenburg position (25.0 ± 2.3, 25.0 ± 1.9, and 28.3 ± 2.3, resp.) and at the 60 min of surgery (24.2 ± 2.1, 24.8 ± 2.2, and 29.5 ± 1.1, resp.). The time to apply the supraglottic airway devices was shorter in the i-gel group (12.2 (1.2), 12.9 (1.0), and 6.7 (1.2), resp., P=0.001). There was no difference between the groups in terms of their fiber optic imaging levels. pH was measured at the anterior and posterior surfaces of the pharyngeal region after the supraglottic airway devices were removed; the lowest pH values were 5 in all groups. We concluded that initial oropharyngeal leak pressures obtained by i-gel were lower than proseal and supreme, but increased oropharyngeal leak pressures over time, ease of placement, and lower airway morbidity are favorable for i-gel

Clinical Study Comparison of the Proseal, Supreme, and I-Gel SAD in Gynecological Laparoscopic Surgeries

We compared proseal, supreme, and i-gel supraglottic airway devices in terms of oropharyngeal leak pressures and airway morbidities in gynecological laparoscopic surgeries. One hundred and five patients undergoing elective surgery were subjected to general anesthesia after which they were randomly distributed into three groups. Although the oropharyngeal leak pressure was lower in the i-gel group initially (mean ± standard deviation; 23.9 ± 2.4, 24.9 ± 2.9, and 20.9 ± 3.5, resp.), it was higher than the proseal group and supreme group at 30 min of surgery after the trendelenburg position (25.0 ± 2.3, 25.0 ± 1.9, and 28.3 ± 2.3, resp.) and at the 60 min of surgery (24.2 ± 2.1, 24.8 ± 2.2, and 29.5 ± 1.1, resp.). The time to apply the supraglottic airway devices was shorter in the i-gel group (12.2 (1.2), 12.9 (1.0), and 6.7 (1.2), resp., = 0.001). There was no difference between the groups in terms of their fiber optic imaging levels. pH was measured at the anterior and posterior surfaces of the pharyngeal region after the supraglottic airway devices were removed; the lowest pH values were 5 in all groups. We concluded that initial oropharyngeal leak pressures obtained by i-gel were lower than proseal and supreme, but increased oropharyngeal leak pressures over time, ease of placement, and lower airway morbidity are favorable for i-gel

Intensive Care of a Weil's Disease With Multiorgan Failure

Leptospirosis is a commonly encountered type of zoonosis, especially in tropical regions. There is insufficient data regarding its frequency in non-tropical regions such as Turkey. Although leptospirosis presents with a mild icteric form in nearly 90% of cases, it can lead to Weils disease characterized by fever as well as fulminant hepatorenal and respiratory failure, in approximately 5 - 10% of cases. In this case report, we present a patient with Weil's disease, complicated with multiorgan failure

Anesthesia management in kidney transplantation patients: Retrospective evaluation

Kidney transplantation comes first for treating and improving living standards in patients with end-stage renal disease. The developments in surgical techniques on kidney transplantation and the specific immunosuppressive agents contributed to improving the function of graft for more extended periods. In addition, developments of anesthesia also contributed to this success. The purpose of the study was to present anesthesia management applied on 40 kidney transplant recipients who were carried out from alive and cadaver donors with a current literature review. The ages, genders, accompanying systemic diseases, whether or not the graft was received from live donor or a cadaver, hot/cold ischemia times, anesthesia and surgery times of the participants were recorded. In addition, postoperative analgesia management, postoperative complications and hospital stays of the patients were also recorded. We believe that graft preservation and patient comfort will be increased with good analgesia management, graft protection, by using selected anesthetics and protecting the kidney blood flow, and by close hemodynamic follow-up in kidney transplant patients. [Med-Science 2019; 8(1.000): 169-72

Effect of different positive end-expiratory pressures in donor liver transplantation patients on hemodynamics and ICU admission period: A Prospective, randomized, double-blind study

Donors are generally volunteers without any sanitary problems. For this reason, security of the anesthesia practice and ICU admission period is significant. The goal of present study was to determine whether there was any important coalition among different positive end-expiratory pressure (PEEP) level hemodynamics and ICU admission in donor patients. This study was performed with40 patients who underwent general anesthesia. Patients were divided into two groups by their PEEP as0 cm H20 in the first group (group Z), and 10 H20 in the second group (group H). We investigated the data concerning demographical data, perioperative values, hemodynamic parameters, intraoperative blood loss, andICU admission. Patient characteristic,characteristicsand perioperative values were similar among the groups. Mean arterial pressure, and central venous pressure were importantly different among the groups (P.05). We have concluded that our data pool is low and single-centered,we determined that PEEP values (10 cm H2O) may be a decisive element for the ICU admission after donor patients. [Med-Science 2019; 8(1.000): 208-10

Organizational Commitment Of Military Physicians

An individual's loyalty or bond to his or her employing organization, referred to as organizational commitment, influences various organizational outcomes such as employee motivation, job satisfaction, performance, accomplishment of organizational goals, employee turnover, and absenteeism. Therefore, as in other sectors, employee commitment is crucial also in the healthcare market. This study investigates the effects of organizational factors and personal characteristics on organizational commitment of military physicians using structural equation modeling (SEM) on a self-report. cross-sectional survey that consisted of 635 physicians working in the 2 biggest military hospitals in Turkey. The results of this study indicate that professional commitment and organizational incentives contribute positively to organizational commitment, whereas conflict with organizational goals makes a significantly negative contribution to it. These results might help develop strategies to increase employee commitment, especially in healthcare organizations, because job-related factors have been found to possess greater impact on organizational commitment than personal characteristics.WoSScopu