Aim: In this study we aimed to administer sedoanalgesia with propofol and ketamine combination in patients undergoing planned minor urologic interventions with limited anesthesia. By combining these ...two medications, lower doses may be used, and we aimed to provide sufficient sedation, analgesia and amnesia without disrupting hemodynamic and respiratory stability and to increase patient and surgeon satisfaction. Material-Method: The study included 53 patients with planned minor urologic interventions aged from 19 to 85 years and physical situation ASA I-III. After six hours starvation, patients were taken to the surgery. Patients were monitored for electrocardiography (ECG), oxygen saturation (SPO_2) and non-invasive blood pressure. For use if necessary a nasal O_2 cannula was inserted. A vein in the back of the left hand was opened and 5 ml/min isotonic sodium chloride infusion was begun. Patient heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP) and oxygen saturation (SpO_2) values were measured and a 5 point sedation scale (Table 1) was used to measure sedation scores. Basal values were recorded (0 min). Later patients were randomly divided into two groups with Group I administered intraurethral lidocaine gel for local anesthesia by the surgeon, while Group II were administered intravenous 0.015 mg/kg midazolam, 0.5 mg/kg 1% ketamine and 0.5 mg/kg 1% propofol by the authors for sedoanalgesia. At five minute intervals the HR, SAP, DAP, MAP, SpO_2 values and sedation scores were measured and recorded. Results: Statistical evaluation found a statistically significant increase in SAP, DAP and MAP values measured at the 5^(th) minute in Group I patients compared to preoperative values. In Group I patients, when the heart rate measured in the 1st and 5^(th) minutes are compared with preoperative values there was a statistically significant increase identified. In Group II patients, there was a statistically significant fall in SpO_2 values in the 1st and 5th minutes compared with preoperative values. When patient and surgeon satisfaction are compared with Group I, Group II was found to be statistically significantly higher. Though the blood pressure and heart rate increases in Group I patients were statistically significant, they were not at levels that required clinical intervention and/or treatment. Similarly the SpO_2 decrease observed in Group II patients did not fall below 90% in any patient in spite of being statistically significant and rose again without clinical intervention and/or treatment. Conclusion: In this study we showed that sedoanalgesia administration with propofol and ketamine may be an alternative method for patients undergoing minor urology interventions that does not disrupt hemodynamic and respiratory stability, does not delay patient discharge, has low side effect incidence and has high patient and surgeon satisfaction.
Objectives:
Postoperative retching and vomiting is an important cause of morbidity that may lead to patient
discomfort, distress, and complications. Stimulation of acupuncture points has been shown ...to be effective in
the prevention as well as treatment of PONV. The current treatments of choice are the 5-hydroxytryptamine
type 3-antagonists, such as ondansetron. We aimed to evaluate the efficacy and side-effects of either transcutaneous
electrical acupoint stimulation (TEAS) or Ondansetron compared to a control group receiving no treatment
in the prevention of postoperative retching and vomiting.
Subject and design:
This randomized, controlled, prospective study was carried out in a group of 90 children
(in three equal randomly assigned groups), aged between 4 and 12 who underwent tonsillectomy under
general anesthesia. In the first group, electrical stimulation via surface electrodes on acupoints Neiguan and
Shangwan was performed (20 Hz, 5 minutes). The second group received a single dose of Ondansetron (0.15
mg · kg
-1
). No treatment was given to the control group.
Outcome measures:
The frequency of retching and vomiting attacks and side-effects were noted on the day
of surgery in the postanesthesia care unit and the day surgery care unit, on the day of surgery after discharge,
and on the first day after surgery. A satisfaction scale was completed by each family.
Results:
There was a significant difference between the treatment groups and the control group in the incidence
of emetic episodes occurring in the day surgery care unit and on the day after discharge (
p
< 0.001). In
the ondansetron group, side-effects were seen in more patients than in the other groups (
p
< 0.001). The satisfaction
scores of the parents were greater in the treatment groups than in the control group (
p
< 0.05).
Conclusion:
Application of TEAS on sedated children is an easy, painless, reliable and effective method for
the prophylaxis of postoperative retching and vomiting in pediatric tonsillectomy.
Aim: Patient-controlled analgesia methods are more effective than conventional analgesia methods for the management of postoperative pain. Patient-controlled analgesia is often preferred as it has ...less sedative effect, minimum complications, high patient satisfaction and has positive effects on the healing process of patients. The aim of this study was to research patient-controlled analgesia methods that were used for postoperative pain control in a training and research hospital. Material And Methods: Retrospectively we reviewed the records of patients who were ASA physical status I-II-III, older than 18 years and underwent procedures for orthopedic surgery, general surgery, neurosurgery, ear, nose and throat surgery, chest surgery, urology, hand surgery or plastic surgery in Numune Training and Research Hospital. Results: A total of 449 patients were administered patient-controlled analgesia in Numune Training and Research Hospital. 67% of patients were administered patient controlled analgesia via epidural vs. 33% of patients administered patient controlled analgesia via intravenous route. Patients' age gender, ASA class, primary disease requiring surgery, method of surgery, duration of surgery, anesthetic technique, drugs used for postoperative analgesia, the amount of analgesic drug consumption, the time to administration of analgesic drug, VAS scores at bolus time, the postoperative analgesic consumption in the first 24 hours blood pressure, heart rate, respiratory rate, side effects, and patient satisfaction level were evaluated. Conclusions: As a result of the study on 449 patients administered patient-controlled analgesia in Numune Training and Research Hospital between April 2011 and December 2011, the administration of patient controlled analgesia via epidural was preferred over than the administration of patient controlled analgesia via intravenous route.
Amaç: Biz retrospektif olarak yaptığımız bu çalışmada; bir yıllık dönemde acil servise başvuran zehirlenme olguları ile ilgili verileri toplamayı, demografik ve etyolojik özellikleri ile ...prognozlarını araştırarak, literatür ile karşılaştırmayı amaçladık.
Gereç ve Yöntemler: Ankara Numune Eğitim ve Araştırma Hastanesi(ANEAH) Acil Servisi'ne 01.09.2006 ile 31.08.2007 tarihleri arasındaki bir yıllık süreçte akut zehirlenme nedeniyle başvuran 14 yaş üstü tüm olgular; yaş ve cinsiyet dağılımları, zehirlenme nedenleri, prognoz ve mortalite oranları açısından araştırıldı.
Bulgular: Akut zehirlenme nedeniyle acil servise gelen 1288 olgunun 790'ı (%61.3) kadındı. Yaş ortalaması kadınlarda 28.5±15.1 yıl, erkeklerde 31.3±16.3 yıl idi. En sık karşılaşılan zehirlenme nedenleri; ilaçlar(%58.69), karbon monoksit(%19.25), alkol (%8.15) ve mantar(%6.99) idi. Tüm olguların %53.1'i intihar amaçlı zehirlenmelerdi ve kadınlarda bu oran daha yüksekti (%70). Olguların %85.7'si acil serviste, %8'i dahiliye kliniklerinde, %6.3'ü ise yoğun bakım ünitelerinde izlendi. Yoğun bakımda kalış süreleri ortalama 3.77±2.05 gündü. Mortalite oranı %0.31 olarak bulundu.
Sonuç: Sonuç olarak; zehirlenme olguları sıklıkla, genç kadınlarda ve ilaç alımı şeklinde görülmektedir. Olgulara acil müdahalenin olabildiğince erken yapılması ve gerektiğinde yoğun bakımlarda izlenmesi, mortalitenin azaltılması yönünde büyük öneme sahiptir. Ama daha da önemlisi yaygın olarak kullanılan ve ulaşılması kolay olan analjezik ve antidepresan gibi ilaçların kontrollü kullandırılması gerektiği kanısındayız.
Objective: In this retrospective study we aimed to gather one year data about intoxication cases admitted to emergency service, examine their demographic and etiologic characteristics and compare these with literature.
Material and Methods: Cases older than 14 years admitted to Ankara Numune Reseach and Training Hospital Emergency Service between 1st September 2006 and 31th August 2007 because of acute poisoning examined for age and gender distribution, poisoning etiology, prognosis and mortality rates.
Results: 790(61.3%) of 1288 people who came to the emergency service because of acute poisoning were female. Mean age was 28.5±15.1 years and 31.3±16.3 years in female and in male patients respectively. Most common cause of the poisonings were drugs(58.69%), carbonmonoxide(19.25%), alcohol(8.15%) and mushroom(6.99%). Of all the events 53.1% were attempts to suicide and this rate was 70% in females. While 85.7% of the cases were followed in emergency service, 8% in internal medicine clinic and 6.3% in ICU. For all the patients, mean duration in ICU was 3.77±2.05 days. Mortality rate was found to be 0.31%.
Conclusions: It can be concluded that intoxication is encountered in females more commonly and most common with a drug. The carrying out of urge interventions as possible as early and observation in ICU is of great importance. That is why we are in opinion that the usage of the medicines such as analgesics and antidepressant drugs which are easy to reach should be taken under control.
Low-Magnetic-Field Soft Gamma Repeater Rea, N; Esposito, P; Turolla, R ...
Science (American Association for the Advancement of Science),
11/2010, Letnik:
330, Številka:
6006
Journal Article
Recenzirano
Odprti dostop
Soft gamma repeaters (SGRs) and anomalous x-ray pulsars form a rapidly increasing group of x-ray sources exhibiting sporadic emission of short bursts. They are believed to be magnetars, that is, ...neutron stars powered by extreme magnetic fields, B approximately 10¹⁴ to 10¹⁵ gauss. We report on a soft gamma repeater with low magnetic field, SGR 0418+5729, recently detected after it emitted bursts similar to those of magnetars. X-ray observations show that its dipolar magnetic field cannot be greater than 7.5 x 10¹² gauss, well in the range of ordinary radio pulsars, implying that a high surface dipolar magnetic field is not necessarily required for magnetar-like activity. The magnetar population may thus include objects with a wider range of B-field strengths, ages, and evolutionary stages than observed so far.
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