Transversus abdominis plane block with different bupivacaine concentrations in children undergoing unilateral inguinal hernia repair: A single-blind randomized clinical trial

BACKGROUND: Current knowledge on the ideal local anesthetic concentration for the ultrasound-guided transversus abdominis plane block (TAPB) in pediatrics is scarce. The purpose of this study is to compare the efficacy of US-guided TAPB at two different concentrations of bupivacaine in pediatrics undergoing unilateral inguinal hernia repair. METHODS: After random allocation, 74 children aged 1-8 were randomized to receive US-guided TAPB by using 1 mg.kg RESULTS: Sixty-four children were recruited for the study. Postoperative pain scores were equal between the two groups. There was no need for a rescue analgesic in any group after the postoperative 6 CONCLUSION: TAPB using 1 mg.kg TRIAL REGISTRATION: This trial was retrospectively registered at Clinicaltrals.gov , NCT04202367

Peripartum Cardiomyopathy and Critical Care Follow-Up

Peripartum cardiomyopathy is rare but carries a high risk of mortality during pregnancy with systolic heart failure. It may occur during the last month of pregnancy or following five months after birth. The clinical symptoms can usually be confused with the physiological changes of pregnancy. Therefore the disease is often diagnosed late and requires a multidisciplinary approach. In this report, we try to describe the clinical presentation of a 40-year-old pregnant patient with systolic heart failure at postoperative first day and its management in the intensive care unit

Investigating antimicrobial features and drug interactions of sedoanalgesics in intensive care unit: an experimental study

Study Objective: Aim of this study was to evaluate antimicrobial effects and interaction between analgesic combinations of fentanyl citrate, dexmedetomidine hydrochloride and tramadol hydrochloride on Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa and Candida albicans which are some of the most common nosocomial infection related microorganisms. Design: In vitro prospective study. Setting: University Clinical Microbiology Laboratory. Measurements: In order to evaluate in vitro antimicrobial effects and interaction between analgesic combinations, tramadol hydrochloride, fentanyl citrate and dexmedetomidin were used against S. aureus ATCC 29213, K. pneumoniae, E. coli ATCC 25922, P. aeruginosa ATCC 27853 and C. albicans ATCC 10231 standard strains by microdilution method. Main Results: According to microdilution assays tramadol has shown the most efficient antimicrobial activity also it has been observed that 10 .g/ml concentrated dexmedetomidine has antimicrobial effects on S. aureus, K. pneumoniae and P. aeruginosa. Fentanyl has displayed evident inhibitory potency on the pathogens except for Klebsiella pneumoniae, nevertheless our predefined minimum concentration inhibited growth by 9.5 %. Fentanyl and dexmedetomidine together exhibited more antimicrobial effect on P. aeruginosa and E. coli growth. Additionally, when the three drugs examined together, microbial inhibition occurred more than expected on E. coli again and also on C. albicans growth. Conclusions: Our results revealed the antimicrobial properties and synergy with the different combinations of fentanyl, dexmedetomidine and tramadol against the most common nosocomial infection agents in the ICU. This is the first study in the literature looking into the microbial interactions of opioids and sedative drugs but more research is needed in order to define clinico-laboratory correlation.WOS:00070670730000

Large Intraatrial Mass as a Cause of Acute Respiratory Failure: An Anesthesiologic Approach to Preserve Cardiorespiratory Cycle and Literature Review

Büyük damarlardan köken alan jinekolojik tümörler oldukça ender gözlenirler. Kan akımı boyunca göç ederek kronik süreçte kardiyak boşluklara kadar uzanabilirler. Semptom verecek boyutlara ulaştıklarında acil operasyon gereksinimi doğabilir. Cerrahi ve anesteziyolojik yönetimi zor olan bu hastalar hemodinamik ve respiratuar komplikasyonlara açıktır. Bu olgu sunumunda akut solunum yetmezliği ile başvruan hastada ender gözlenen intrakardiyak yerleşimli jinekolojik tümör cerrahisinin anesteziyolojik yönetimini literatür ışığında anlatmaya çalıştık.Gynecologic tumors originating from great vessels are observed quite rarely. Migrating along with the bloodstream; they can extend into cardiac chambers in chronic process. As they reach to larger sizes, and become symptomatic urgent surgery may be needed. These patients whose surgical and anesthesiologic management create difficulties are open to hemodynamic and respiratory complications. In this case report; we tried to describe anesthesiologic management of a patient who had intracardiac gynecologic tumor, and presented with acute respiratory failure, in the light of literature