Dexmedetomidine and remifentanil as adjuncts to total intravenous anesthesia with propofol

Aim: The aim was to compare the effects of dexmedetomidine and remifentanyl in total intraveous anesthesia [TIVA] in laparoscopic cholecystectomy operations

Methodology: Forty, 18-60 years old, elective laparoscopic cholecystectomy patients were included in the study. In Group D, TIVA was performed by 150 microg/kg/min propofol and 0.5 microg/kg/h dexmedetomidine infusions. In Group R patients, TIVA was performed with 150 microg/kg/min propofol and 0.5 microg/kg/min remifentanil infusions. Systolic blood pressure, heart rate, SpO[2], end tidal CO[2] were recorded. All infusions were terminated at the end of surgery. Adequate spontaneous respiration, extubation, and response to verbal commands; and Aldrete score >/= 9 times, postoperative pain scores and vital parameters in the postoperative period were recorded. Patient-controlled analgesia pump was used in all postoperative patients. Total analgesic consumption, patients' first analgesic needs were recorded

Results: Intraoperative Systolic blood pressure, diastolic blood pressure and heart rate values remained significantly lower in remifentanyl group compared to those in dexmedetomidine group [p < 0.05]. First postoperative analgesia time was shorter and hemodynamic parameters were significantly higher in this group [p < 0.05]. Postoperative recovery of dexmedetomidine group remained more stable in terms of VAS values [p < 0.05]

Conclusions: Remifentanil provides a potent intraoperative anesthesia compared with dexmedetomidine; however, dexmedetomidine may be considered in TIVA as an option for a stable postoperative recovery

perioperative anaphylactic reaction caused by latex in a patient with no history of allergy

Latex is one of the most common causes of intraoperative anaphylactic reactions

Latex anaphylaxis may lead to signi" cant morbidity and even may sometimes be fatal. During a surgical operation of a 19 year old male, for removal of a seminal vesicular cyst under general anesthesia, sudden appearance of classic signs of an anaphylactic reaction, e.g. skin eruptions, hypoxemia, hypotension, ! ushing, edema and bronchospasm alerted us. Antihistaminics, steroids and adrenaline were administered

It was assumed that the most possible cause of this anaphylactic reaction could have been latex

Therefore, all latex gloves in use were changed to latex free ones. The boy recovered and after 24 hours of observation in intensive care unit [ICU], he was shifted to urology clinic