[Comparison the effects of prilocaine and the addition of dexketoprofen and dexamethasone to prilocaine for intravenous regional anesthesia]. / Intravenöz rejyonel anestezi tekniginde prilokain, prilokaine eklenen deksketoprofen ve deksametazonun etkinliklerinin karsilastirilmasi

OBJECTIVES: The aim of this study was to compare the anesthetic and analgesic effects of prilocaine alone, prilocaine added dexketoprofen and dexamethasone during intravenous regional anesthesia (IVRA). METHODS: Forty five patients undergoing forearm or hand surgery were randomly assigned to one of three groups to receive (Group P) 3 mg/kg 0.5% prilocaine; (Group PDK) 3 mg/kg 0.5% prilocaine plus 50 mg dexketoprofen; (Group PDM) 3 mg/kg 0.5% prilocaine plus 8 mg dexamethasone in total 40 ml volume for IVRA. The onset and duration of sensory and motor blocks, hemodynamic datas, duration of analgesia and tourniquet, time to first analgesic requirement, visual analog scale (VAS), total analgesic consumption in 24 hours and patient satisfaction score were assessed and recorded. RESULTS: Time to onset of sensory block was found to be longer in Group P (p<0.05), though no significance was found according to sensory block recovery times amoung groups. Time to onset of motor block was found to be longer and recovery time of motor block was found to be shorter in Group P (p<0.05). Time to first analgesic requirement was found to be longer in Group PDK,and was found to be high in Group PDM than Group PDK(p<0.05). The VAS scores was found to be high and patient satisfaction scale was found to be low in Group P (p<0.05). CONCLUSION: The addition of dexketoprofen and dexamethasone to prilocaine during IVRA improves the quality of both anesthesia and analgesia moreover dexketoprofen provides beter postoperative analgesia during the first 24 hour after surgery.

Prevention of propofol injection pain in children: a comparison of pretreatment with tramadol and propofol-lidocaine mixture.

BACKGROUND: The pain on propofol injection is considered to be a common and difficult to eliminate problem in children. In this study, we aimed to compare the efficacy of pretreatment with tramadol 1 mg.kg(-1)and propofol-lidocaine 20 mg mixture for prevention of propofol induced pain in children. METHODS: One hundred and twenty ASA I-II patients undergoing orthopedic and otolaryngological surgery were included in this study and were divided into three groups with random table numbers. Group C (n=39) received normal saline placebo and Group T (n=40) received 1 mg.kg(-1) tramadol 60 sec before propofol (180 mg 1% propofol with 2 ml normal saline) whereas Group L (n=40) received normal saline placebo before propofol-lidocaine mixture (180 mg 1% propofol with 2 ml %1 lidocaine). One patient in Group C was dropped out from the study because of difficulty in inserting an iv cannula. Thus, one hundred and nineteen patients were analyzed for the study. After given the calculated dose of propofol, a blinded observer assessed the pain with a four-point behavioral scale. RESULTS: There were no significant differences in patient characteristics and intraoperative variables (p>0.05) except intraoperative fentanyl consumption and analgesic requirement one hr after surgery among the groups (p<0.05). Both tramadol 1 mg.kg(-1) and lidocaine 20 mg mixture significantly reduced propofol pain when compared with control group. Moderate and severe pain were found higher in control group (p<0.05). The incidence of overall pain was 79.4% in the control group, 35% in tramadol group, 25% in lidocaine group respectively (p<0.001). CONCLUSIONS: Pretreatment with tramadol 60 sec before propofol injection and propofol-lidocaine mixture were significantly reduced propofol injection pain when compared to placebo in children.

Oral magnesium lozenge reduces postoperative sore throat: a randomized, prospective, placebo-controlled study.

BACKGROUND: Postoperative sore throat (POST) is an undesirable complaint after orotracheal intubation. Magnesium is a noncompetitive N-methyl-D-aspartate receptor antagonist thought to be involved in the modulation of pain. The present study aimed to investigate the effect of preoperative administration of oral magnesium lozenge on POST. METHODS: Seventy patients undergoing orthopedic surgery were randomly allocated into two groups, to either receive placebo (control) or magnesium lozenges (magnesium) to be dissolved by sucking 30 min preoperatively. Patients were assessed for incidence and severity (four-point scale, 0-3) of POST at 0, 2, 4, and 24 h postoperatively. The primary outcome was sore throat at 4 h after surgery. The secondary outcome was the severity of POST at four evaluation time-points postoperatively. RESULTS: The incidence of POST at 4 h was higher in control group than in magnesium group (95% CI: 26%, 14-42%; P=0.032). The highest incidence of POST occurred at the second hour after surgery, with the rate of 23% in the magnesium group and 57% in the control group (95% CI: 34%, 20-51%; P=0.007). The severity of POST was significantly lower in the magnesium group at 0 (P=0.007) and 2 h (P=0.002). The incidences of POST at 0 and 24 h and severity scores at 4 and 24 h were not significantly different between the groups. CONCLUSIONS: The administration of magnesium lozenge 30 min preoperatively is effective to reduce both incidence and severity of POST in the immediate postoperative period.