Comparison of proseal laryngeal mask and endotracheal tube for airway safety in pediatric strabismus surgery

To compare proseal laryngeal mask airway [PLMA] with an endotracheal tube [ET] for airway safety, maintained ease of insertion, and hemodynamic stability in pediatric strabismus surgery [PSS]. This prospective-randomized clinical study was carried out in the Department of Anesthesiology, Faculty of Medicine, Gaziantep University, Turkey between April 2008 and July 2009. Eighty American Society of Anesthesiology [ASA] I-II children, weight 10-30 kg, aged between 1-12 years undergoing PSS were selected. The anesthesia was induced with 8% sevoflurane, 50% nitrous oxide/oxygen mixture, and a neuromuscular blockade with 0.5 mg/kg atracurium in both groups. After a sufficient dosage of anesthesia, the patients were randomized into 2 groups [Group P: PLMA, n= 40, Group T: ET, n=40] and an airway management device; either a PLMA or ET was inserted. The number of placement attempts, placement success or failure, success or failure of a gastric suction tube placement during the procedures and perioperative complications were assessed. Thirty-eight patients [95%] in the PLMA group, 39 [97.5%] patients in the ET group were successfully placed with a PLMA and ET on the first attempt [p>0.05]. There were no statistically significant differences in the hemodynamic parameters, end-tidal carbon dioxide, and complications. This study revealed that PLMA may offer an alternative airway to ET wherein positive pressure ventilation was the preferred choice for children undergoing PSS

Ophthalmic manifestations of 107 cases with hemolysis, elevated liver enzymes and low platelet count syndrome

To present various ophthalmologic disorders in a clinical series of hemolysis, elevated liver enzymes and low platelet count [HELLP] syndrome cases. This is a prospective clinical study performed between 2002 and 2005. One hundred seven HELLP patients attended in either Departments of Ophthalmology or Obstetrics and Gynecology, Medical School, Gaziantep University, Gaziantep, Turkey were evaluated. Mean age was 25.5 [22-36 years]. Mean levels were 2.5 gravidity, 1.3 parity, 55,200/mm3 platelet counts, 308.7 U/l aspartate transaminase, 255.4 U/l alanine transaminase, and 1711.6 U/I lactate dehydrogenase. Four patients died [3.7%] despite the proper treatments. Cortical blindness was observed in 3 cases [2.7%], serous retinal detachments in 4 [3.7%], and mild hypertension changes in 18 [16%]. Ophthalmic complications are possible during and after this syndrome. Almost all ophthalmologic changes recover after delivery by cesarean section, nevertheless, it is essential that ophthalmologists should be aware of retinal disorders when this fatal complication of pregnancy is encountered