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SUMMARY OBJECTIVE: A significant proportion of patients may experience moderate pain requiring treatment in the postoperative first 24 h following thyroidectomy. The aim of this study was to investigate the evaluation of postoperative patient-reported pain from intraoperative intravenous infusion of lidocaine in patients undergoing thyroidectomy surgery. METHODS: A total of 40 patients with American Society of Anesthesiologists physical status classifications I and II, aged 18-65 years, who were scheduled for elective thyroidectomy with the same indications under general anesthesia at the Ataturk University Medical Faculty's Ear, Nose, and Throat Clinic between November 2019 and February 2020, were divided into two equal groups as randomized and double-blind. Before induction of anesthesia, patients in the lidocaine group were given 1.5 mg/kg lidocaine IV bolus infusion during the operation and until the end of the first postoperative hour, followed by a continuous infusion of 1.5 mg/kg/h. Patients in the control group were given 0.9% isotonic solution according to the same protocol. In the postoperative period, 50 mg of dexketoprofen trometamol was administered and repeated every 12 h. Postoperative pain scores, additional analgesia, and side effects were recorded. RESULTS: Postoperative pain scores were significantly lower in the lidocaine group (n=20) compared to the control group (n=20) at 30 min and 1st, 2nd, 4th, 8th, and 12th h postoperatively (p < 0.05). Additional analgesia requirements were also significantly lower in the lidocaine group than in the control group (p<0.05). CONCLUSION: We recommended the use of intravenous lidocaine infusion intraoperatively in thyroidectomy surgery as it reduces pain scores.
ABSTRACT
Abstract Objectives: Recurrent Aphthous Stomatitis (RAS) a chronic idiopathic oral mucosal disease. But yet the etiology and pathogenesis of RAS are not exactly known, it is thought that inflammation play an important role in the pathogenesis. The aim of this study is to demonstrate the role of systemic inflammation among the possible etiological factors of RAS and to find the possible diagnostic correlation between Systemic Immune Inflammation Index (SII). Methods: Patients who were consulted the otolaryngology outpatient clinic and diagnosed with RAS between 2019-2021 were retrospectively analyzed. Neutrophil/Lymphocyte Ratio (NLR), Platelet/Lymphocyte Ratio (PLR) and SII values were calculated based on the results of complete blood count. Demographic and hematological parameters between control and RAS groups were compared. The statistical significance level was considered as <0.05. Results: There was no statistically significant difference between the control and RAS groups in terms of sex and age distributions (p = 0.566 and p = 0.173, respectively). SII, NLR and PLR values were significantly higher in the RAS group compared to the controls (p < 0.001, p < 0.001 and p = 0.001, respectively). A very strong correlation between SII and NLR, moderately strong correlation between SII and PLR and moderate correlation between NLR and PLR values were detected (respectively ρ: 0.813, 0.719, 0.532; p-values <0.001). Conclusion: SII, NLR and PLR has significantly higher levels in the RAS group compared to the control group, that it supports the role of systemic inflammation in the etiopathogenesis of RAS. In addition, the results show that SII is a valuable marker for inflammation. Level of evidence: 4. HIGHLIGHTS RAS is a chronic, idiopathic, ulcerative oral mucosal disease. SII is a new and inexpensive biomarker that can easily be calculated using the platelet, neutrophil, and lymphocyte count. SII may be a valuable marker to demonstrate the role of systemic inflammation in RAS etiopathogenesis. Vascular, thrombotic, and inflammatory processes are thought to have a role in RAS activation.
Resumo Objetivo: A estomatite aftosa recorrente (EAR) é uma doença crônica idiopática da mucosa oral. Embora sua etiologia e patogênese não sejam totalmente conhecidas, acredita-se que a inflamação possa desempenhar um papel importante. O objetivo deste estudo é demonstrar o papel da inflamação sistêmica entre os possíveis fatores etiológicos da estomatite aftosa recorrente e encontrar uma possível correlação diagnóstica com o índice de inflamação imunológica sistêmica, SII. Método: Foram analisados retrospectivamente pacientes avaliados no ambulatório de otorrinolaringologia e diagnosticados com estomatite aftosa recorrente entre 2019-2021. A relação neutrófilos/linfócitos, a relação plaquetas/linfócitos e os valores de SII foram calculados com base nos resultados do hemograma completo. Parâmetros demográficos e hematológicos dos grupos controle e de pacientes foram comparados. O nível de significância estatística foi considerado como <0,05. Resultados: Não houve diferença estatisticamente significante entre os grupos controle e com estomatite aftosa recorrente quanto à distribuição por sexo e idade (p = 0,566 e p = 0,173, respectivamente). Os valores de SII, a relação neutrófilos/linfócitos e a relação plaquetas/linfócitos foram significantemente maiores no grupo de pacientes em relação aos controles (p <0,001, p <0,001 e p = 0,001, respectivamente). Foi detectada uma correlação muito forte entre SII e relação neutrófilos/linfócitos, uma correlação moderadamente forte entre SII e relação plaquetas/linfócitos e uma correlação moderada entre valores da relação neutrófilos/linfócitos e relação plaquetas /linfócitos (ρ: 0,813, 0,719, 0,532 respectivamente; p-valores <0,001). Conclusão: SII, relação neutrófilos/linfócitos e relação plaquetas/linfócitos apresentam níveis significantemente maiores no grupo com estomatite aftosa recorrente quando comparados ao grupo controle, o que corrobora o papel da inflamação sistêmica na sua etiopatogênese. Além disso, os resultados mostram que o SII é um marcador inflamatório valioso. Nível de evidência: 4. HIGHLIGHTS A estomatite aftosa recorrente é uma doença ulcerativa crônica idiopática da mucosa oral. O SII (do inglês Systemic Immune Inflammation Index) é um biomarcador novo e de baixo custo que pode ser facilmente calculado que usa a contagem de plaquetas, neutrófilos e linfócitos. O SII pode ser um marcador valioso para demonstrar o papel da inflamação sistêmica na etiopatogênese da estomatite aftosa recorrente. Acredita-se que processos vasculares, trombóticos e inflamatórios tenham um papel na ativação da estomatite aftosa recorrente.
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SUMMARY OBJECTIVE: In coronavirus disease 2019, a rapidly progressive inflammatory process is considered to be the main cause of organ damage and mortality. Therefore, the importance of anti-inflammatory treatments such as tocilizumab is increasing. METHODS: A total of 107 patients who received tocilizumab between March 2020 and March 2021 were included in the study. The primary termination point was mortality. We compared surviving and deceased patients by the stage of the disease and where the drug was given (service or intensive care unit). RESULTS: The mean age was 60.8±14.6 years (minimum 29 years, maximum 96 years). According to the WHO staging system, 16 (15%) patients had moderate, 47 (43.9%) patients had severe, 44 (41.1%) patients had a critical illness. Although all patients were admitted to the service, 26 (24.3%) patients received tocilizumab in the intensive care unit. Of 107 patients, 80 (74.7%) survived and 27 (25.2%) died. Mortality was found to be significantly higher in critical patients (96.3%), severe patients (3.7%), and moderate patients (0%) (p<0.001). Peripheral oxygen saturation measured at admission was found to be significantly lower in patients who died. The initial saturations (p=0.008) were found to have independent effects on mortality. CONCLUSION: The results showed that tocilizumab is an effective treatment option for coronavirus disease 2019 disease and reduces mortality, but the key point is timing.