32 research outputs found
Case Report Is It Possible to Maintain Consciousness and Spontaneous Ventilation with Chest Compression in the Early Phase of Cardiac Arrest?
No full textChest compression is important in cardiopulmonary resuscitation. However, life support algorithms do not specify when chest compression should be initiated in patients with persistent spontaneous normal breathing in the early phase after cardiac arrest. Here we describe the case of a 69-year-old man who underwent femoral bypass surgery and was extubated at the end of the procedure. After extubation, the patient's breathing pattern and respiratory rate were normal. The patient subsequently developed ventricular fibrillation, evident on two monitors. Because defibrillation was ineffective, chest compression was initiated even though the patient had spontaneous normal breathing and defensive motor reflexes, which were continued throughout resuscitation. He regained consciousness and underwent tracheal extubation without neurological sequelae on postoperative day 1. This case highlights the necessity of chest compression in the early phase of cardiac arrest
Severe hypoxemia follows hypoxic pulmonary vasoconstriction and/or hypoxic pulmonary vasoconstriction inhibition by inhaled anesthetics: prognostic potential of 100% shunt fractions
No full textBroken Racz catheter during application (Case report)
No full textThe most important complication of lumber disc hernia operations is Failed Back Surgery Syndrome (FBSS), which goes with fibrotic adhesions at the surgical site. The primary treatment applied to the cases that develop FBSS is the placement of Racz catheter under floroscopy and application of epidural neuroplasty which is a three-day procedure. However, this intervention, from which patients benefit a great deal, has some important complications during and after the application. One of these complications is that some pieces of Racz catheter may be broken out and retain at some levels of epidural space and subcutaneous tissue during placement and removal. General approach is to remove the retaining piece surgically. However, there is a less common view that, instead of removing the retaining piece, the patient should be followed up strictly and regularly in terms of neurologic complications. In our case, we decided to perform epidural neuroplasty to the patient diagnosed as FBSS. However, during the placement of the catheter, it was trapped in the left side of L-5-S-1 foramen by accident due to dense fibrotic tissues, and the subcutaneus part retained in the epidural space. Monthly follow-ups for 12 month were proposed to the patient, while surgery was not recommended. At the end of this period, no sign of infection was observed and neurologic and radiologic findings of the patient did not worsen. It is also interesting that a remarkable recovery was observed in the patient's clinical situation
Is there an advantage in using low-dose intrathecal bupivacaine for cesarean section?
No full textSpinal anesthesia for cesarean section is associated with a high incidence of maternal hypotension. The aim of this study was to assess the efficacy of low-dose bupivacaine with fentanyl to reduce the incidence of hypotension in spinal anesthesia for cesarean section. Forty pregnant women undergoing elective cesarean section were randomly allocated to two groups; those receiving 10 mg bupivacaine to group B (n = 20) and those receiving 4 mg bupivacaine plus 25 mu g fentanyl to group BF (n = 20); the agents were given intrathecally with patients in the sitting position, with a combined spinal-epidural technique. Sensory block was adequate for surgery in all patients. Hypotension occurred in all patients in group B (100%) and in 15 patients in group BF (75%). The incidence of hypotension, number of ephedrine treatments, and need for ephedrine were significantly greater in group B than group BF. Three patients in group BF required i.v. fentanyl supplementation after delivery. In 1 of these patients, i.v. fentanyl was not adequate, and epidural supplementation of 1% lidocaine was required. The development of hypotension after spinal block in subjects undergoing cesarean section was not prevented despite low-dose (4 mg) bupivacaine plus 25 mu g fentanyl, but the severity of maternal hypotension, and the number of ephedrine treatments and the total dose of ephedrine were decreased
Is It Possible to Maintain Consciousness and Spontaneous Ventilation with Chest Compression in the Early Phase of Cardiac Arrest?
No full textChest compression is important in cardiopulmonary resuscitation. However, life support algorithms do not specify when chest compression should be initiated in patients with persistent spontaneous normal breathing in the early phase after cardiac arrest. Here we describe the case of a 69-year-old man who underwent femoral bypass surgery and was extubated at the end of the procedure. After extubation, the patient’s breathing pattern and respiratory rate were normal. The patient subsequently developed ventricular fibrillation, evident on two monitors. Because defibrillation was ineffective, chest compression was initiated even though the patient had spontaneous normal breathing and defensive motor reflexes, which were continued throughout resuscitation. He regained consciousness and underwent tracheal extubation without neurological sequelae on postoperative day 1. This case highlights the necessity of chest compression in the early phase of cardiac arrest
Severe hypoxemia follows hypoxic pulmonary vasoconstriction and/or hypoxic pulmonary vasoconstriction inhibition by inhaled anesthetics: prognostic potential of 100% shunt fractions
No full textSavaş sırasında sivil ateşli silah yaralanmalarını takiben ortaya çıkan mortalite: Retrospektif bir kohort araştırması
No full textLung perfusion in hemorrhagic shock of rats: The effects of resuscitation with whole blood, saline or Hes 6%
No full textThis study was undertaken to determine the effects of various resuscitation regimens on lung perfusion following resuscitation from hemorrhagic shock. Fourty male Sprague-Dawley rats (250-300 g) were used. The rats were divided randomly into four groups (n = 10 for each) and were sedated with intramuscular ketamine (100 mg/kg). We measured blood pressure, rectal temperature and lung perfusion using radioscintigraphy with a technetium colloid indicator. The systolic blood pressure was decreased 75% by removing blood via v. jugularis in the first three groups and group 4 was accepted as the control group, and blood volume was not diminished. Then the first three groups were resuscitated with autologous blood containing 125 units heparine/ml in group 1, saline in group 2, and hydroxyethyl starch (HES) 6% in group 3. After the correction of hypovolemia, all animals were injected 100 Bg (0.1 cc) technetium 99 in macroaggregated albumin (Tc-99m MAA) via penil vein. After injection of Tc-99m MAA, 3 minutes fixed images were detected by a gamma camera in posterior position at 15 minutes and 5 hours. Tc-99m MAA wash out rate in lung was determined quantitatively at 5 hours. Compared to a control group, lung perfusion was decreased significantly in groups resuscitated with saline, and HES 6% while perfusion was restored with autologous blood. We conclude that heparinized autologous blood saved lung capillary circulation in hemorrhagic shock in rats. (C) 2001 Tohoku University Medical Press
Tramadol Iontophoresis Added to Treatment of Knee Osteoarthritis
No full textAmaç: Bu çalışmanın amacı diz OA hastalarında tedaviye eklenen tramadol iyontoforezinin tek başına uygulanan tedavi yöntemlerine (transkütanöz elektriksel sinir stimülasyonu, sıcak kompres, ultrason ve egzersiz tedavisi) üstün olup olmadığını incelemektir.Yöntem ve Gereçler: Çalışmaya Fizik Tedavi ve Rehabilitasyon polikliniğine başvuran 72 hasta dahil edildi. Hastaların tanısı, Amerikan Romatoloji Birliği (ACR) Diz OA kriterlerine göre konuldu. Hastalar rastgele iki gruba ayrıldı. İki haftalık süre boyunca Grup 1'deki hastalara fizik tedavi, Grup 2'deki hastalara ise tedaviye ek olarak tramadol iyontoforezi uygulandı. Hastalar tedaviden önce, 10. seansı takiben ve 1. ve 3. aylarda görsel ağrı skalası (GAS) ve Western Ontario ve McMaster Üniversiteleri Osteoartrit İndeksi (WOMAC) kullanılarak ağrı ve fonksiyonel kapasitelerine göre değerlendirildi.Bulgular: Yaş ortalaması ve ortalama ağrı süresi kontrol grubunda 58,53±8,38 ve 5,00±2,66 yıl, tramadol iyontoforez grubunda ise 58,15±7,70 ve 4,71±2,70 yıldı. Tedavi öncesinde gruplar arasında yaş ortalamaları, ortalama ağrı süresi, vücut kitle indeksi, VAS ve WOMAC skorları açısından anlamlı fark yoktu. 10. seansı takiben ve 1. ve 3. aydan sonra, başlangıç değerleriyle karşılaştırıldığında her iki grupta GAS ve WOMAC skorlarında anlamlı düşüş saptandı (p0.05).Sonuç: Fizik tedaviye eklenen tramadol iyontoforezin tedavi dönemi sırasında diz OA ağrısını rahatlatmada faydalı olabileceği sonucuna vardıkObjective: The objective of the present study was to investigate whether tramadol iontophoresis added to therapy is superior to the therapy methods alone (transcutaneous electrical nerve stimulation (TENS), hot pack, ultrasound, and exercise therapy) in patients with knee OA. Materials and Methods: A total of 72 patients who admitted to the outpatient clinic of Physical Medicine and Rehabilitation were included in this study. The diagnosis was based on the American College of Rheumatology (ACR) criteria for knee OA. The patients were randomly separated into two groups. Group 1 received physical therapy and Group 2 received tramadol iontophoresis in addition to the therapy for a period of two weeks. Patients were evaluated according to pain and functional capacity assessed using visual analogue scale (VAS) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) before therapy and following the 10th session, and at 1 and 3 months.Results: The mean age and duration of the knee pain were 58.53±8.38, 5.00±2.66 years in the control group and 58.15±7.70, 4.71±2.70 years in the tramadol iontophoresis group. There were no significant differences between groups in the mean age and duration of the knee pain, body mass index (BMI), VAS and WOMAC scores before therapy. Following the 10th session, and after 1 and 3 months, VAS and WOMAC scores were significantly decreased in both groups when compared with the baseline values (p<0.001). VAS scores were significantly lower in the tramadol iontophoresis group compared to controls following the 10th session (p<0.001). However, no significant difference was found between WOMAC scores of the tramadol iontophoresis and control groups (p>0.05). Conclusion: We conclude that tramadol iontophoresis added to physical therapy may be useful for relieving pain of knee OA during the treatment perio
Lidocaine for prevention of propofol injection-induced pain: A prospective, randomized, double-blind, controlled study of the effect of duration of venous occlusion with a tourniquet in adults
No full textAbstractBackground: Many patients experience pain on injection of propofol. The use of lidocaine to prevent propofol injection pain is common. The analgesic effect of pre-injected lidocaine has been found to increase when a tourniquet is used.Objective: The aim of this study was to compare the effectiveness of various venous occlusion times with lidocaine analgesia to prevent pain during propofol injection.Methods: In this prospective, randomized, double-blind, controlled study, women aged 18 to 45 years, classifed as American Society of Anesthesiologists physical sta- tus I or II, who were scheduled to undergo elective surgery under general anesthesia induced with propofol, were randomly assigned to 1 of 5 groups: group 1, 2% lidocaine 20 mg in saline in a total volume of 10 mL and no venous occlusion; group 2, 2% lidocaine 20 mg in saline in a total volume of 10 mL plus venous occlusion for 15 seconds; group 3, 2% lidocaine plus venous occlusion for 30 seconds; group 4, 2% lidocaine plus venous occlusion for 60 seconds; and group 5, saline 10 mL and no venous occlusion. When the first 25% of the calculated propofol dose was administered, patients were asked about propofol-induced pain using a verbal pain scale (0 = no pain; 1 = mild pain; 2 = moderate pain; and 3 = severe pain). All patients and the anesthesiologist who evaluated pain severity were blinded to the study preparation being used.Results: The study comprised 100 women who were randomly divided into 5 groups of 20 patients each. Significantly more patients in group 5 (18 [90%] patients; P < 0.05) reported pain compared with the other treatment groups. In groups 2, 3, and 4, in which venous occlusion was applied, pain was reported during propofol injection in 6 (30%), 7 (35%), and 2 (10%) patients, respectively. The incidence of reported pain was significantly greater in group 1 (lidocaine without venous occlusion) than in group 4 (P < 0.05); however, the incidence of pain was similar in group 1 compared with groups 2 and 3.Conclusions: The present study found that pretreatment with lidocaine 20 mg with or without venous occlusion significantly reduced the incidence and the severity of pain during the injection of propofol when compared with the group with no venous occlusion administered saline. In addition, pretreatment with lidocaine 20 mg plus venous occlusion for 60 seconds significantly reduced the incidence of propofol-induced pain compared with lidocaine without venous occlusion
