Curcumin and dexmedetomidine prevents oxidative stress and renal injury in hind limb ischemia/reperfusion injury in a rat model.

Curcumin and dexmedetomidine have been shown to have protective effects in ischemia-reperfusion injury on various organs. However, their protective effects on kidney tissue against ischemia-reperfusion injury remain unclear. We aimed to determine whether curcumin or dexmedetomidine prevents renal tissue from injury that was induced by hind limb ischemia-reperfusion in rats. Fifty rats were divided into five groups: sham, control, curcumin (CUR) group (200 mg/kg curcumin, n = 10), dexmedetomidine (DEX) group (25 µg/kg dexmedetomidine, n = 10), and curcumin-dexmedetomidine (CUR-DEX) group (200 mg/kg curcumin and 25 µg/kg dexmedetomidine). Curcumin and dexmedetomidine were administered intraperitoneally immediately after the end of 4 h ischemia, just 5 min before reperfusion. The extremity re-perfused for 2 h and then blood samples were taken and total antioxidant capacity (TAC), total oxidative status (TOS) levels, and oxidative stress index (OSI) were measured, and renal tissue samples were histopathologically examined. The TAC activity levels in blood samples were significantly lower in the control than the other groups (p < 0.01 for all comparisons). The TOS activity levels in blood samples were significantly higher in Control group and than the other groups (p < 0.01 for all comparison). The OSI were found to be significantly increased in the control group compared to others groups (p < 0.001 for all comparisons). Histopathological examination revealed less severe lesions in the sham, CUR, DEX, and CUR-DEX groups, compared with the control group (p < 0.01). Rat hind limb ischemia-reperfusion causes histopathological changes in the kidneys. Curcumin and dexmedetomidine administered intraperitoneally was effective in reducing oxidative stress and renal histopathologic injury in an acute hind limb I/R rat model.

Effects of end tidal CO2 and venous CO2 levels on postoperative nausea and vomiting in paediatric patients.

OBJECTIVE: Postoperative nausea and vomiting (PONV) is a common complaint of paediatric surgical patients. The aim of this prospective study was to compare the effects of end tidal CO2 (PeCO2) and venous CO2 (PvCO2) in laryngeal mask (LMA) and face mask (FM) ventilation on the occurrence of PONV in paediatric patients with surgical interventions in the inguinal region. To date, no data regarding these parameters on PONV are available. PATIENTS AND METHODS: Ninety children were randomized using the sealed-envelope method. Group 1 consisted of 45 patients whose airway was managed with LMA; Group 2 consisted of 45 patients whose airway was managed with FM. Induction of anaesthesia was performed via administration of 8% sevoflurane in a mixture of air/oxygen in all patients. In both groups, manually controlled ventilation was applied. Five (t1) and fifteen (t2) min after the start of surgery, venous blood samples were obtained and PeCO2 was determined. RESULTS: PeCO2 (t2) and PvCO2 (t2) levels and the occurrence of PONV were significantly increased in Group 2 compared to Group 1 (p < 0.005 for all). In both groups, the occurrence of PONV was positively correlated with BMI, PeCO2 (t2), and PvCO2 (t2) levels (p < 0.05 for all), whereas it was inversely correlated with SpO2 levels (p < 0.05 for all) in a bivariate analysis. We found that the PeCO2 (t2) and PvCO2 (t2) levels were independently associated with the occurrence of PONV in both groups. CONCLUSIONS: Our results showed that elevated levels of PeCO2 (t2) and PvCO2 (t2) are independent risk factors for PONV, and these parameters may be used as adjunctive tools to assess the occurrence of PONV.

Anesthetic management in hydatid disease: a review of 435 cases.

BACKGROUND AND AIMS: Hydatid cyst diseases are still a problem in Turkey, especially in the east and southeast of Anatolian Region, as well as in many other places in the world. In this study a retrospective review was made of the anesthetic management for surgical and interventional treatment of 435 patients with hydatid cysts. The study data were collected between January 1997 and December 2012 at Harran University Hospital, Sanliurfa, Turkey. MATERIALS AND METHODS: Patients' demographics and localization of the cysts were recorded. Suitable anesthetic and surgical management were performed to the cysts according to their locations. Four hundred thirty-five patients had general anesthesia with a midazolam premedication and one of them was treated by sedation. RESULTS: Of the 435 patients, 251 were females (57.7%) and 184 males (42.3%) and ages ranged from 1 to 74 years (mean: 36.3 ± 25.4). These include; preoperative using of steroids and antihistamines to prevent the allergy possibility, intraoperative hypotension and tachycardia and administration of colloids, and improvement of postoperative anaphylaxis. Anaphylaxis was observed in only two patients who undertook percutaneous aspiration. Also bronchospasm was developed in four patients during the postoperative period and successfully treated with standard bronchodilatators. CONCLUSIONS: Anaphylactic reaction during operation is a serious complication, but a very rare one. Prophylactic use of antihistamine and steroid drugs were reduced allergy and anaphylaxis.

Optimal wrist position for long and short axis ultrasound guided radial artery cannulation.

BACKGROUND: The radial artery is the most common site for arterial cannulation. Procedures for improving radial artery cannulation have involved direct visualization of the vessel with ultrasonography (US). The aim of this study evaluate the short axis and long axis radial artery measurements at 0º, 45º, 60º wrist joint angle and find out the optimal wrist joint angle for long and short axis US guided radial artery cannulation. MATERIALS AND METHODS: This study was approved by the Institutional Ethical Committee and the study was performed in accordance with the ethical principles for human investigations, as outlined by the Second Declaration of Helsinki. One hundred fifty-two (90 men and 62 women, 18-48 years of age, mean age: 32.9 ± 6.1) healthy volunteers were recruited. The radial artery distance between skin and height, width, area in short axis and radial artery distance between skin and height was measured in long axis at 0º, 45º, 60º wrist joint angle were measured. Results. Short axis radial artery distance between skin, width, height, area and long axis radial artery distance between skin, height were statistically significantly different among 0º, 45º, 60º (p< 0.05; for all comparisons). Short axis width was statistically significantly increased at 45º compared to at 0º (p< 0.001;). Short axis radial artery distance between skin and height at 45º were statistically significantly decreased than at 0º (p< 0.001; for all comparisons) and long axis skin distance and height at 45º were also statistically significantly decreased than at 0º (p< 0.001; for both comparisons). Short axis radial artery skin distance and area at 60º is statistically significantly decreased than at 45º (p< 0.001; for both comparisons) and also long axis height of radial artery at 60º is statistically significantly decreased than at 45º (p< 0.001;). CONCLUSIONS: Angle increment up to 45º might help clinicians for radial artery cannulation in short axis plane whereas this angle increment maneuver decreased the arterial height in long axis which might be a potential disadvantage for cannulation.

Effect of N2O on nausea and vomiting via intraabdominal pressure.

BACKGROUND AND OBJECTIVE: In this study we aimed to investigate whether there is an effect of N2O on postoperative nausea and vomiting (PONV) via intraabdominal pressure (IAP). METHODS: A total of 40 patients with risk class ASA I-II and age ranging between 20 and 50 years were enrolled in the study. The patients were monitored for electrocardiography (ECG), peripheral oxygen saturation (SpO2), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), end-tidal carbon dioxide (ETCO2) and body temperature. IAP was measured by a central venous pressure manometer placed in the urine catheter. Heart rate (HR), SpO2, SBP, DBP, MBP, ETCO2, body temperature and IAP were measured before the induction of anesthesia and every 10 minutes throughout the operation. Nausea and vomiting were questioned at the first and second postoperative hours. The patients were randomly grouped into two groups. Induction in both groups was provided using 2 mg/kg propofol, 2 µg/kg fentanyl and 0.1 mg/kg vecuronium, and endotracheal intubation was performed. The maintenance of anesthesia was provided by 40 % O2 + 60 % N2O, 1-2 % sevoflurane and 50 µg fentanyl + 2 mg vecuronium every 45 minutes in the first group. In the second group, 60 % dry air was used instead of 60 % N2O. RESULTS: There was no significant difference in terms of HR, SpO2, SBP, MBP, ETCO2, body temperature, nausea-vomiting and IAP. CONCLUSIONS: In conclusion, we think that N2O usage during the general anesthesia in patients without intraabdominal problems may increase IAP level for some degree whereas it does not increase PONV. In addition, N2O usage does not change ETCO2 values (Tab. 3, Fig. 3, Ref. 32).