Makale Arama

Saddle block is an ideal procedure that can provide sufficient anesthesia by protecting hemodynamic stability especially in elder patients with high cardiac risk. A 52 years old male patient with bladder tumor who was scheduled for transurethral bladder resection (TUR-B) had history of hypertension, diabetes mellitus and congestive heart failure. Echocardiography showed that LVEF was 20%; RVEF was 28% and there were insufficiency (MVI) of third degree, insufficiency (TVI) of second degree, biventricular global hypokinesia and remarkable dilatation on the right and left structures of the heart. The patient was considered as having ASA class IV. He had TUR-B under saddle block. In conclusion, we considered that saddle blockade was a more safe and efficient anesthetic procedure rather than neuroaxial blockade or general anesthesia for the highrisk patient who had bladder tumor.

Aim: The aim of this study is to compare the prophylactic administration of ondansetron with haloperidol to determine its effects in reducing postoperative nausea and vomiting after middle ear surgery. Material and Method: Forty patients scheduled for middle ear surgery under general anesthesia were randomly allocated in two groups to receive either haloperidol IV 2 mg (Group I) or ondansetron IV 4 mg (Group II) 5 minutes before induction of anesthesia. Standart general anesthesia was applied. During postoperative 24 hours nausea-vomiting was evaluated by using verbal descriptive scala. Results: The nausea-vomiting score was not statistically different between the groups (p>0.05). The incidence of nausea-vomiting and the need for rescue antiemetics were not statistically significant (p>0.05). There was no difference of side effects between the groups (p>0.05). Conclusion: It was concluded that haloperidol 2 mg is as effective as ondansetron 4 mg for the prevention of postoperative nausea and vomiting in patients undergoing middle ear surgery.

35 cases with congenital dislocation of the hip were treated conser-vatively. 7 of the cases (20 per cent) were boys and 28 (80 per cent) were girls. The average age of the cases was 7.5 months (range, 2 to 24 months). The left hip was dislocated in 8 (23 per cent), the right in 7 (20 per cent) and both in 20 (57 per cent) patients. 14 cases were treated with von Rosen splint. In the other cases, skin traction was applied first. Then closed reduction and hip spica cast was applied ender general anesthesia in 19 cases, open reduction was applied in two cases. Adductor tenetorny was nessary in 7 patients (ten hips). The patients were followed average 6.5 months and avascular necro-sis was not determined. The conservative treatment was not sufficient in 2 patients.

Aim: We aimed to evaluate the anesthetic approach to a 6 years old female child, clinically diagnosed as Hurler syndrome, undergoing umbilical hernia repair and adenoidectomy operation, under the light of literatüre data. Case Report: Premedication was omitted. The case monitorised with EKG, non invasive arterial pressure, peripheric oxygen saturation (SpO2) and taken under operation. It is assumed to be a difficult airway case bacause of anatomical features of Hurler Syndrome, tracheostomy and difficult airway algorithm prepared. Preoxygenation via face mask with 3L/min 100% O2 inhalation applied to the case before induction. Anesthesia induced with increasing sevoflurane concentrations in 100% oxygen and fentanyl 1µg/kg. Neuromuscular blockage was maintained with 1.5 mg/kg iv succinylcholine. 18 mm diameter endotracheal tube was placed into trachea by using Macintosh blade (No:2) at third attempt. Anesthesia was maintained with 2% sevofluran in 50% O2-50% N2O. The patient was extubated without any complication at the end of the surgery. Conclusion: In Hurler’s sydrome; patients should be evaluated carrefully prior to operation. It is vital to monitor the patient in peroperative and postoperative period.

The presence of cardiac disease in pregnancy is still one of the most important reason of maternal mortality. The possibility of acute coronary syndrome increases in pregnancy. Birth with caesarean section provides proper hemodynamic monitoring and management in parturients with cardiac disease. However the ideal anesthetic to be applied to parturient with cardiac disease is controversial. Although regional anesthesia is usually preferred method, general anesthesia may be applied in some special cases. Invasive monitoring reduces mortality and morbidity in cardiac patients undergoing general anesthesia. Opioid use reduces the stress response to surgery and intubation. If the use of opioid is required before birth, remifentanil is the ideal agent because of its rapid onset of action and metabolism. In this case, we aimed to present our general anesthesia experience on a parturient with high cardiac risk where regional anesthesia is contraindicated because of the use of anticoagulation.

40 ASA I-II patients undergoing abdominal surgery were included in the study. They were randomly allocated into two groups. Midazolam was used for maintenance. Group 1 (n=20) recieved iv 0.1mg/kg bahis increments as needed while group Il (n=20) recieved 0.1mg/kg/hr continious infusion. The effects on hemodynamics was stu-died. The effects of postoperative flumazenil on emergence and hemodynamics were alsa evaluated. Ali patients were premedicated with 1M 0.07mg/kg midazolam+0.5mg/kg atropine. 0.3mg/kg midazolam, 0.5mg/kg atracurium was used for induction. Maintenance was supplemented with 50%02+50%N20 and iv 1mg/kg meperidine in both groups. The SAB,DAP,HR were recorded at the first minute after induction, intubation, incision and every 10 mi-nutes perioperatively. Sp02 was monitored continiously. One minute after extubation the alertness was assesed with the Alertnes-Sedation Scale and iv 0.2mg flumazenil was giyen. Flumazenil was repeated every minute until the score became 1. Student's t test was used for analysis (p<0.05 was considered as significant). The he-modynamic parameters were stable in both groups. The total midazolam dose was sigificantly lower and emer-gence was more rapid in group Il. Either incremental bahis or infusion midazolam provides stable and sa-tisfactory anaesthesia maintenance. Because of lower midazolam dosage and more rapid emergence, the infusion method is more preferable.

In 0-72 months aging children with early childhood caries, general anesthesia is often preferred due to the following reasons; the non-cooperation based on age, anxiety development during the dental procedures and long treatment sessions. It is known that early childhood caries have a significant impact on the quality of life of child patients’ and their families’. In the assessment of quality of life scores, different questionnaires were developed for children and their parents. Today, Parental Perception Questionnaire and Family Impact Scale, which are composed of two parts including Early Childhood Oral Health Impact Scale, is used for children under 6 years old age. This study included 158 patients who received comprehensive oral rehabilitation under general anesthesia in Necmettin Erbakan University, Department of Pediatric Dentistry and their parents. Demographic information and dmft values of the patients were recorded before the procedure. Parents were asked to complete the relevant questionnaire at the beginning of the procedure and at the 2nd and 4th weeks following the procedure. The data were statistically analyzed by the SPSS program. It was considered that if the effect size was greater than 0.7, a major change occurring in the data exchange. A statistically significant decrease in all values was observed after the treatments performed under the general anesthesia. The greatest reduction was found in the oral symptoms and functional status of the child. In conclusion, dental procedures performed under general anesthesia in children with early childhood caries appear to have a positive impact on the quality of life of patients and their families.

Aim: Propofol is a frequently used anesthetic in outpatient anesthesia and pain is often experienced when propofol is injected. Opioids are effective in preventing the propofol pain injection. In this study it’s aimed to evaluate effectivity of sufentanil, a selective μ receptor agonist 5-10 times more effective analgesic than fentanyl, in propofol injection pain. Material and method: Sixty patients scheduled for elective surgery under general anesthesia were randomly allocated to one of two groups to receive either saline 2 ml or 5μg sufentanil before propofol was injected. Each patient was given one of these agents intavenous via 20 G cannula on the dorsum of the hand in 10-20 second. Then 5 ml propofol at room temperature was injected. Pain was assesed verbally and scored none (0), mild (1), moderate (2), severe (3). Results: There was no statistically difference in demographic datas between two groups. In saline group, the incidence of pain (% 80) was higher than in the flidsufentanil group (%46,7) the result was statistically significant (p< 0,05). Conclusion: Pretreatment with 5μg sufentanil was effective in reducing the propofol injection pain. So, we thought that sufentanil can be useful for preventing propofol injection pain.

Aim: Multiple sclerosis (MS), is characterized by demyelination of different parts of brain and spinal cord and episodic neurologic symptoms. In this case report we aimed to present a patient, and highlighting anesthetic management for these patients. Case Report: A 42 year old man who had neurogenic bladder with primer progressive multiple sclerosis undergoing bladder stone operation is discussed. Conclusion: Stress such as surgery or general anesthesia may be associated with an exacerbation of the disease. We thought that to carry out desflurane and remifentanil combination used safely in anesthetic management for MS.

Transturethraltresection was carried ovt succesfully in the fifty-seven patient with benign prostatic hyperpiasie, bladder neck obstruction, cancer of the prostate and b7adcler betwen 1984 and 1987 spinal anesthesia wa2 giyen to eleyen patiens and general anesthesia forty-five patiens. T ype of anesthesia (spirıal and general), tissue size removed, operation time and irrigation fluid have been investigated cor;.e?ation with hemorraghie. There was correlation betwen operation time and hemor-raghie in both the spinal and general anesthesia. Correlation, between tissue size removed and hemorraghim was found ver} important in both. Correlati.on with hemorraghi.e of irrigation fluid was important in ()nin spinal anesthesie. The hemorraghie in the spinal anesthesia was much lessthan general anesthesia.

Pulmonary edema following the obstruction of an upper airway is an uncomman and unpredictable clinical situation. In this case report, it was aimed to discuss the ethiology, pathophsiology, diagnosis and treatment methods of negative pressure pulmonary edema (NPPE) that developed just after the resolution of laringopasm in the patient who underwent to gynecologic operation. Early diagnosis and treatment can affect the mortality and morbidity in NPPE.

Arthrogryposis Multiplex Congenita is a congenital disorder characterized by joint contractures. This is often due to contractures of joints in patients undergoing orthopedic procedures is required. Short neck, micrognathia and joint contractures, causing the neck and jaw movement limitations may cause difficulty in intubation. In this presentation anesthesia management in a case of Arthrogryposis multiplex congenita were evaluated because of recurrent operations

Aim: To present a squamous cell metaplasia of bladder which is induced by a rarely seen pathology called recurrent eosinophilic cystitis. Case report: Twenty four years old female patient, admitted to our clinic with frequent urination, suprapubic pain and dysuria. Microscopic hematuria was found in urine analysis. We performed cystoscopy under general anestesia and an edematous, ulcerative lesion located at the trigone was found. The lesion was resected transuretrally. Pathology revealed eosinophilic cystisis. The patient began antihystaminics and aniticholinergics. The symptoms of the patient relapsed 2 months after medical treatment. This time the cystoscopy revealed a similiar lesion in a different area than the first one. The lesion was resected transurethrally. The biopsy revealed squamous cell metaplasia of epithelium and eosinophilic cell infiltration. Patient began steroid and antihistaminic combination postoperstively. The patients has been followed up to 6 months without any symptom. Result: Medical treatment is effective in the control of reccurencies of eosinophilic cystitits. Recurrent eosinophilic cystitis might cause squamous cell metaplasia in the bladder mucosa.

Intravenous administration of rocuronium often leads to injection pain. We investigated the effect of diphenhydramine pretreatment, reducing the incidence of pain on rocuronium injection. This randomized study was carried out on ASA I-II, 60 adult patients for elective surgery under general anesthesia. Patients were divided into two groups, thirty patients in each. After tournique application on forearm and inflation to 70 mmHg, 2 ml saline, 2 ml (20 mg) diphenhydramine were given in Group S (n=30) and Group D (n=30) respectively. 30 seconds after the pretreatment, tournique was deflated and 10 mg rocuronium was injected over 10 seconds. The patients were asked immediately to assess pain with 4 point pain scale. No significant differences were noted in the number of patiens who had no pain and mild pain in group S and D (p>0.05). Number of patients who had moderate and severe pain was higher in Group S than Group D (p

The choice of anaesthetics for ceasarean sections is important for both the nevvborn and the mother. Emergence phenomena (EP) is observed with clinical doses of ketamine that can be avoided with lower doses. Ketamine- thiopentone or ketamine-midazolam combinations were used for ceasarean section anaesthesia induction. Side effects and newborn APGAR scores were evaluated. After institutional approval and informed consent 42 women (ASA I) were randomly allocated to two groups . Group I (n=21) recieved induction doses of IV ketamine 1mg/ kg+thiopentone 3mg/kg, group II (n=21) recieved ketamine 1 mg/kg+midazolam 0.2mg/kg. Both groups were in- tubated with IV1-1.5mg/kg succinylcholine. The patients were ventilated with 100% 02 until the umblical cord was clamped. Anaesthesia was maintained with 50%02+50%N20, 1-1.5% isoflurane and atracurium. Heart rate, ar- terial pressures were recorded before the operation, induction, skin incision and perioperatively. The APGAR sco­ res were evaluated at the first and 5th minutes. The patients were intervieved 12 hours postoperatively for EP. The data was analysed with Student's t test. The two groups were hemodynamicaly comparable (p>0.05). EP was observed in 2 patients of group I. The APGAR scores were similar in both groups (p>0.05). Both anaesthetic combinations shovved similarity in APGAR scores and anaesthesia. Because of its fewer side effects ke- tamine+midazolam combination is more favourable.

In our study; we tried to evaluate the int-raosseous route for water-electrolyte replacement and anesthetic induction with ketamine in children. 48 patients whose ages are between I and 6 years, were divided into three groups. 2 mg/kg ke-tamine intraosseous (10) in group 1; 2 mglkg ke-tamine intravenous (IV) in group II, and 6 mgike ke-tamine intramuscular (IM) in group II was used for induction. The maintenance of anesthesia in all three groups were administered with 1.5 % tsof lurane and N20. Nystagmus was considered as the begining time of induction for ketamine. During the operation the heard rate (HR), systolic arterial blood pressure (SABP) and diastolic arterial blood pressure (DABP) was recorded and the comp-lications of the intraosseous route were evaluated. When we have compaired the SABP, DABP and HR values of each group recorded during operation, it was found that there were no significant sta-tistically difference among them. As a conclusion; if the intravenous approach is impossible, the intraosseous route is a safe al-ternative for water-electrolyte replacement and in-duction with ketamine.

Aim: Pain is often experienced when propofol is injected. Lidocaine is often used and most effective agent in preventing the propofol pain injection. In this study we aimed to assess if esmolol given before propofol is as effective as lidocaine in reducing the incidence of the pain. Material and method: Ninety three patients scheduled for elective surgery under general anesthesia were randomly allocated to three groups to receive either esmolol 20 mg, 0< or lidocaine 20 mg or saline 2ml intravenously before propofol was injected. Then 2 mg/kg propofol at room temperature was injected as 2 ml every 4 seconds. Pain was assessed verbally and scored as none (0), mild (1), moderate (2), severe (3). Results: There was no statistically difference in demographic datas between three groups. In the control group, the incidence of pain (% 77,42) was higher than in the esmolol group (% 32,26) and lidocaine group (% 38,71), and the results were statistically significant (p<0,05). The incidence of pain in the esmolol and lidocaine groups were similar and there was no statistically difference between these two groups (p>0,05). Conclusion: Pretreatment with esmololwas equally as effective as lidocaine in reducing the propofol injection pain. Because of this effect, we thought that esmolol can be used for preventing propofol injection pain in appropriate patients.

Aim: Dexamethasone is used for prevention of postoperative nausea and vomiting (PONV). Most important side effect of steroid use is adrenal suppression. In this study we aimed to evaluate the effects of single dose of 2, 4, 8 mg dexamethasone on adrenal glands by measuring serum cortisol levels, and also in preventing postoperative nausea and vomiting. Material and Method: Forty patients scheduled for elective total nasal reconstruction under general anesthesia were included to the study. Patients were randomly divided into four groups. Immediately before the induction of anesthesia 2 ml intravenous serum physiologic to group S, 2 mg dexamethasone to group D2, 4 mg dexamethasone to group D4, 8 mg dexamethasone to group D8 were applied. Blood sampling was done from the patients at preoperative visit day (t0), preinduction and before dexamethasone injection (t1), after induction at 2. (t2), 6.(t3), 9. (t4),12. (t5),18.(t6), 24.(t7) and 72. (t8) hours for measurement of serum cortisol levels. Results: Demographic data, anesthetic and surgical times were similar in the groups. The 8 mg and 4 mg dexamethasone doses were found to be more effective than the control and D2 groups in prevention of PONV. In 4 and 8 mg groups no increase was observed in the cortisol levels. In 8 mg group there was significant suppression in cortisol levels between 9.and 24.hours of induction. Conclusion: Both 4 and 8 mg dexamethasone doses are effective for prevention of PONV. Because 8 mg dexamethasone causes suppression of serum cortisol levels, we think that the application of 4 mg dexamethasone is safer than 8 mg.

Aim: We aimed to investigate probable effects of inguinal hernia repairing under local anesthesia on duration of hospital stay, postoperative complications and pain. Material and Method: This prospective study was conducted between October 2000 and December 2005. In 193 patients with unilateral inguinal hernia. Prilocain 1% solution was used as local anesthetic maretial. Thiopentone sodium (6 mg/kg), sucsinilycholine chloride (1 mg/kg), atracurium besylate (0.4 mg/kg), isoflurane olumcombination was used for general anesthesia. Analgesia was obtained with diclofenac sodium (75 mg x 2 per day) in postoperative period. The length of hospital stay, postoperative pain, postoperative complications, satisfaction were recorded and relation between used anesthesia method was investigated. The results obtained were compared. Results: A total 193 patients were operated under general or local anesthesia (respectively 18.13%-81.87%). Sixty-nine point seven percent of patients were discharged postoperative first day in operated under local anesthesia group but only 20% of patients were discharged postoperative second day in operated under general anesthesia group. Postoperative pain scores at sixth hour was 2.82±0.93 in local anesthesia group and 6.62±1.57 in general anesthesia group (p<0.05). In the group oparetod under general anesthesia, the postoperative complicaties such as urinery retantion and nausea were recorded more often. Conclusion: Inguinal hernia repairment under local anesthesia is suitable with less length of hospital stay, reduced postoperative pain scor and less complications such as urinary retantion and nausea.

İn this study; lumbar and thoracic epidural applications under sedation in school age children were presented. Thoracic epidural catheters were inserted before elective thoracotomies and were combined with general anes­ thesia. Lumbar epidural catheters were inserted in the emergency orthopedic cases that had contraindication for general anesthesia and were combined with sedation.

 

Aim: The aim of this study was to primarily investigate the effects of selected anesthesia method on anxiety, patient satisfaction and pain level in elective caesarean section, and secondarily obtain information about quality of service.

Materials and Methods: The study was carried out as a prospective questionnaire in the Department of Anaesthesiology and Reanimation the Meram Medical Faculty Hospital of Necmettin Erbakan University between June 2017 and August 2017, on 160 volunteers aged between 18 and 45 years for whom elective cesarean section under General Anesthesia (GA) or Spinal Anesthesia (SA) was planned. Demographic data of the patients such as age, place of residence, education level, number of children, and cesarean experiences were recorded. In the preoperative and postoperative period, anxiety levels were measured by State-Trait Anxiety Inventory (STAI-D), pain levels were measured by Visual Analog Scale (VAS) scores and satisfaction levels were evaluated at postoperative 6th and 24th hours by (Quality of Recovery: QoR 40 T) questionnaire.

Results: There was no statistically significant difference between the patients' preoperative and postoperative anxiety scores and demographic data (p> 0.05). Patients with previous cesarean experience had lower preoperative anxiety levels (p <0.05). The STAI-D scores and the numbers of patients with anxiety in the GA and SA groups were similar (p> 0.05).Postoperative anxiety levels were significantly lower in both groups than in the preoperative period (p <0.05). VAS values of the SA group at the 6th and 24th hours were significantly higher than the group treated with GA.(p<0.05). The 24th hour VAS values of the SA group were higher than the VAS values at the 6th hour (p <0.05). In the GA group, VAS values at 24th hour were lower than the VAS values at 6th hour (p <0.05). The satisfaction levels of general anesthesia and spinal anesthesia were similar in the postoperative period (p> 0.05). Complaint of headache was high in SA group while complaint of sore throat was high in GA group(p<0.05). While there was no correlation between anxiety level, VAS values and satisfaction level (p> 0.05), there was a negative correlation between VAS values and pain parameters, which are the subgroup of satisfaction questionnaire, in both groups (p <0.05).

Conclusion: It is concluded that the preferred anesthesia method in elective cesarean section has no effect on anxiety and satisfaction, and the patient satisfaction level and service quality will be improved by providing effective analgesia by reviewing our postoperative pain algorithm.

 

In this study, 60 women who had undergone gynecologic operations or laparo~ies ımder ge-neral anaesthesia allocated randonly into three groups (which had 20 patients each) ta receive patient-controlled analgesia with either meperidine combined 141th antiemetics (in group one with on-dansetron and group two with metoclopramide) m-meperidine alone (group 3-placebo). Bolus doses of meperidine 20 mg, and ondansetron 0,5 nig or me-toclopramide 2,7 mg ?vere used with a lockout time of 5 min. During the first 24 h after surgery the mean (range) dose of ondansetron in the on-dansetron group was 2,9 ± 0,9 nıg and me-toclopramide in the metoclopramide group 14,5 ± 4,3 mg. Signıficantly ftwer patients in ondansetron and mewclopramide groups had nausea (P<0,01 and 0,05 respectively). Side effects were not ob-served in any patient. Significantly More patient had the opinion that patient controlled analgesia had provided excellent analgesia when antiemetics were used.

Introduction: In this study, in order to shed light on the intraparenchymal pressure reduction mechanism of dexmedetomidine, the effect of two different doses of 80 and 320 µg kg-1 on the levels of vasoconstrictor Endothelin-1(ET-1) and vasodilator prostaglandin I2 (PGI2) in blood and cerebrospinal fluid (CSF) in transient global cerebral ischemia model in rabbits was examined. This study was conducted in the Selcuk University Experimental Medicine Research Center between June 2005 and January 2006 and approved by an ethical committee. All rabbits were randomly divided into four groups; six rabbits in each group. In Group 1, a craniotomy was performed and the ischemia was not created. In Group 2, only an ischemia-reperfusion was performed. During reperfusion, 80 µg kg-1 intravenous dexmedetomidine was administered to Group 3, and 320 µg kg -1 intravenous dexmedetomidine was administered to Group 4. After the application of craniotomy and cervical neck dissection of the rabbits in Groups 2, 3 and 4, the bilateral carotid arteries were clamped and an ischemia was performed for one hour. Then, the clamps were removed and reperfusion was performed for one hour. In addition, ıntraparenchymal pressure were recorded after craniotomy and reperfusion. Blood and CSF samples were collected from rabbits after craniotomy in Group 1 and reperfusion in Groups 2,3 and 4 to determine levels of ET-1 and PGI2. Intraparenchymal pressure values after the reperfusion in Group II and IV were significantly higher than Group I( p< 0.05), but any significant increase in Group III (p>0.05). ET-1 levels of both blood and CSF were increased in the group performed ischemia and reperfusion and no treatment (Group II) and the group administered low dose dexmedetomidine (Group III) were similar with the sham group (p>0.05). However, PGI2 levels of CSF were significantly decreased in the group administered low dose dexmedetomidine (p< 0.05). Dexmedetomidine can reduce the intraparenchymal pressure by reducing the level of ET-1 in the transient global cerebral ischemia model.

Aim: We aimed to present the anesthetic management of a case with giant liver hemangioma. Case Report: An 66 years old man with abdominal mass was diagnosed with giant liver hemangioma. Mass excision surgery continued 5.5 hours. The patient was discharged home 5 days later without any problem from department of general surgery. Conclusion: The patients should be evaluated detailed preoperatively and proper preparations must be planned to prevent intraoperative hypotention.

İn this study the effects of low-dose morphine hydrochlorur on rat kidney vvere determined at light microscopical level. A total of 30 Sprague Davvley rats from both sexes (15 male and 15 female) vvere used. Five rats from both sexes vvere served as Controls, vvhereas 10 rats from each sex vvere used as experimental group. Control animals vvere injected subcutaneously vvith physiological şaline (5mg/kg), the animals of experimental group vvere given morphine hydrochlorur at a dose of 5 mg/kg in every other day. At the end of the experiment, the animals vvere perfused vvith buffered formaline (pH=7.4) under anaesthesia, and kidneys vvere extirpated, and morphometrical measurements (thickness, height, length) vvere taken. Follovving, kidney samples vvere processed by means of routine histological techniques and the sections vvere taken at 7pm thickness, and stained. Slides vvere then examined using light microscope. The investigations have revealed that the low-dose-morphine hydrochlorur caused to glomerular destruction, epithelial necrosis and desquamation in both proximal and distal tubuli, vascular hyperemia and hemorrhagies. Based on the findings, it was concluded that the results of this study might be specific to the rat kidney vvhich is devoid of detoxification enzymes in tubuler epithelial cells and a study should be performed on an animal having similar metabolism with human.

Inguinal hernia operations are frequently performed at general surgery clinics. These procedures can be performed not only under general anesthesia but also with methods like spinal anesthesia, epidural anesthesia, and local anesthesia. Inguinal reparations can be successfully performed with local anesthesia especially on older patients, those with comorbidity and significant risk of anesthesia. An ample amount of studies in literature underline the fact that the results of hernia reparations performed under local anesthesia are no different than the results of hernia reparations done under general anesthesia. This report discusses the case of an 87-yearold male patient with comordid diseases like hypertension, diabetes mellitus, congestive heart failure, and chronic kidney failure as well as irreducible inguinal hernia who had to undergo emergency hernia reparation under local anesthesia. Although inguinal hernia reparation under local anesthesia has been comprehensively evaluated in literature, there is very limited information on the reparation of incarcerated inguinal hernias under local anesthesia. Consequently, we think that it is possible to use local anesthesia successfully to surgically treat incarcerated hernias with low risk of strangulation especially on senior and comorbid patients. However, we also believe that it would be of utmost significance to conduct a comparative study between emergency hernia operations performed under local anesthesia and general anesthesia in order to be able to recommend a safer solution on the subject.

Increased intraabdominal pressure decreases the venous return due to compression of vena cava inferior. Lower part of body is supposed to be affected mostly from this hemodynamic changes, especially microcirculation and aftervvard oxygen saturation in lower extremities. We investigated the relationship betvveen intraabdominal pressure and oxygen saturation of lovver extremity measured by pulse oxymetry and vvhether oxygen saturation of leg is an indicator for intraabdominal pressure. VVe employed on 5 dogs vveighing mean 14.2 kg. Under general anaesthesia, pneumoperitoneum was established via Veres cannula and normal air insufflation at 6 different pressure levels ranging 0-50 mmHg and 3 different time intervals. Measured lovver extremity oxygen saturations vvere analysed by bivariate correlation. İntraabdominal pressure shovved a significant negative correlation with lovver extremity oxygen saturation(p=0.001, r=0.97). As a conclusion, lovver extremity oxygen saturation seems tobea reliable indicator for increased intraabdominal pressure. Further clinical and experimental studies are necessary in this subject.

A hundred consecutive patients undergoing various surgery ender general anesthesia were giyen 1.25 mg. Droperidol, 10 ıng. Metoclopramide , 100 mg. Dra-mamine or a sahne placebo intravenously in a doubly - blind random fashion 5 minutes before the end of anesthesia to prevent postoperatiw nausea and vomiting during the first 24 hours postoperativei y. Significantly (p< 0.01 ), fewer of patients giyen droperidol were nauseated and vomited (6.6 %) in comparison with patient giyen saline (incidence of nausea and vomiting was 46 %).1ncidences of nausea and vomiting were sirnilar in patients giyen Metocloprarnide,Dramamine or h is concluded that Droperidol is effectiye in the prevetion and treatment of postoperative nausea and vomiting after general anesthesia but that Metoclopramide or Dramaınine are not.

Thirty patients in ASA-1 group were premedicated with diazepam (10 mg) and atropine (112 mg) and anesthetized with Dolantin, thiopentone sodium, 50% N20, 50% 02 . Vecuronium (0.1 mgfkg) was applied intravenously as muscle relaxant. The effects of vecuronium on heart rale, blood pressure, serum potassium levels and elecirocardiographic changes were evaluated. Blood pressure was not changed and there were not significant changes in heart rate at 2 nd and 5th minutes but the bradycardia following initiation of the surgical intervention was statistically significant (p<0.05). Prolongation of QRS and QT intervals observed in ECG as well as bradycardia. Serum potassium levels were decreased significantly in blood sarnples obtaincd 5 minutes after administration of vecuronium (p<0.01). With regard to our findings, we concluded that vecuronium has no side effects on cardiovascular system.