Adv Clin Exp Med
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Randomized Controlled Trial Comparative Study
The effect of sevoflurane vs. TIVA on cerebral oxygen saturation during cardiopulmonary bypass--randomized trial.
Neuropsychological and neurological deficits are still major causes of mortality and morbidity after cardiac surgery. These complications are thought to be caused by embolisms and cerebral hypoxia. Thus, continuous neuromonitoring is essential during cardiac surgery due to cerebral oxygen desaturation during different periods. Near-infrared spectrophotometry (NIRS), a non-invasive method, appears to offer many advantages for monitoring cerebral oxygenation and hemodynamics. Desaturation of cerebral oxygen may occur at the beginning of cardiopulmonary bypass (CPB) or during the low perfusion and rewarming stages if not corrected. ⋯ Oxygen saturation was higher in the sevoflurane group than in the TIVA group. Thus, the effect of sevoflurane was useful for maintaining cerebral oxygen saturation during CBP.
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Following ischemia/reperfusion injury, antioxidant defense mechanisms may remain insufficient depending on the duration of ischemia which is caused by any reason (MI, after percutaneous coronary intervention, during cardiac surgery). After that, free oxygen radicals increasing within the cell cause structural deterioration. Cytokines which activate a series of reactions that cause tissue damage and inflammatory response are released during reperfusion of ischemic tissues. In this study, we aimed to compare the effects of dexmedetomidine and ketamine in cardiac ischemia/reperfusion injury. ⋯ According to our study, it can be concluded that dexmedetomidine and ketamine have similar effects on reducing myocardial ischemia reperfusion injury. Dexmedetomidine provides better heart rate control but causes hypotension, so, because of cardiac depression, we think that its clinical use may necessitate further investigation.
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The nutrition state of obese patients scheduled to undergo esophageal surgery was evaluated using two nutritional score systems: the mini nutritional assessment (MNA) and the prognostic and nutritional index (PINI). A further comparison of various proteins, lymphocytes and cholesterol was performed using biochemical tests. These factors were compared with post-operative morbidity and mortality in a prospective, descriptive clinical study. ⋯ The study found no differences between post-operative morbidity or mortality and the pre-operative nutrition status of obese patients who underwent surgery due to esophageal cancer.
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Randomized Controlled Trial
Do lubricants with 2% lidocaine gel have an effect on patient comfort in diagnostic cystoscopy?
Patients undergoing both rigid and flexible cystoscopic evaluation suffer from a great deal of pain and discomfort. In this study, we aimed to investigate the effect of lidocaine gel anestesia on patient comfort on diagnostic rigid cystoscopy. ⋯ The application of local anesthetic lidocaine gel in rigid cystoscopy, is a practical, safe and efficient method to improve patient comfort when applied in appropriate dose and waiting duration.
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Diagnosis and treatment of neuropathic pain is an important clinical problem. ⋯ We believe that using S-LANSS scores for the diagnosis of neuropathic pain may help our colleagues as a tool for a quicker differential diagnosis of pain in daily practice.