Comparison of the effects of sedation and general anesthesia in surgically assisted rapid palatal expansion

To compare the effects of sedation and general anesthesia for surgically assisted rapid palatal expansion [SARPE]. This randomized prospective study included 30 patients who were scheduled for SARPE, and was performed between January 2008 to February 2010 in the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Marmara University, Istanbul, Turkey. Patients were allocated into Group S - midazolam + fentanyl sedation [n=15], and Group G - general anesthesia [n=15]. Hemodynamic parameters, duration of anesthesia, surgery, recovery time, time to discharge, visual analogue scale [VAS] pain scores at 30 minutes [min], one hour [hr], 4 hours, 12 hours, and 24 hours, first consumption of analgesic time, total amount of consumption of analgesics, patient and surgeon satisfaction, nausea, and vomiting were recorded. Analgesic time was significantly longer in Group S [p=0.008], and total analgesic consumption was significantly lower in Group S than in Group G [p=0.031]. Patient satisfaction was statistically higher in Group S [p=0.035]. At 30 min, one hr, and 12 hrs, VAS satisfaction scores in Group S were statistically lower than those in Group G, and at 4 hrs and 24 hrs there was no statistical difference in VAS scores for both groups. The use of sedation for outpatient SARPE resulted in lower pain scores at discharge, lower analgesic consumption, and greater patient satisfaction

Single-injection femoral nerve block. Effects on the independence level in functional activities in the early postoperative period in patients with total knee arthroplasty

To investigate the efficacy of single injection femoral nerve block [FNB] on the independence level in functional activities in the early postoperative period in patients with total knee arthroplasty [TKA]. We conducted this prospective, randomized, blinded trial in the Department of Orthopedics and Traumatology, Hacettepe University Hospital Ankara, Turkey, between June 2003 and April 2004. Twenty-three patients scheduled for elective TKA were randomly divided into 3 groups. Group I received preemptive single injection FNB, group II received postoperative single injection FNB, and group III served as a control group. Intravenous morphine patient controlled analgesia [PCA] was used following surgery in all groups. Morphine dose and pain score defined by the visual analog scale [VAS] were recorded postoperatively at the 15th minute, 30th minute, 1st, 4th, 6th, 12th, 24th, and 48th hours. A standard rehabilitation protocol was applied for all patients. The independence level in functional activities was assessed during the first 2 postoperative days and at discharge with the Iowa Level of Assistance Scale [ILAS] and the Iowa Ambulation Speed Scale [IASS]. Physical therapists that enrolled in the study were blinded to the groups. Pain scores were significantly different between the groups [p<0.05]. The preemptive and postoperative FNB group's VAS scores were both significantly lower than the control group [p<0.05]. However, there was no significant difference in VAS scores between preemptive and postoperative FNB groups [p>0.05]. There was no statistically significant difference between the groups in any of the functional scores in the first 2 postoperative days, and at discharge [p>0.05]. Single injection FNB provided effective analgesia in patients undergoing TKA. However, the independence level in functional activities in the early postoperative period was not influenced by the analgesia method