Does smoking affect the onset time of sensory blocks or the duration of motor blocks in parturient women? A randomized controlled trial.

Background: In general, smoking or exposure to secondhand smoke is still common worldwide, and the rate of smoking in women of childbearing age is gradually increasing. Cesarean section rates have been increasing in recent years, and anesthesia guidelines recommend regional anesthesia for cesarean sections. Since nicotine and local anesthetics have different effects on ligand-gated ion channels, smoking may affect spinal anesthesia in pregnant women. Aim: The aim of this study was to investigate the effects of smoking on spinal anesthesia, which is applied for cesarean sections in pregnant women. Patients and. Methods: After approval from the institution's ethics committee, 100 pregnant women were divided into two groups: current smokers (Group S, smoker) (n = 50) and lifelong nonsmokers (Group NS, nonsmoker) (n = 50). The dose of local anesthetic was adjusted according to the height of each patient. After free cerebrospinal fluid flow was observed, all patients were given 20 µµg of fentanyl in 0.05 mg/cm hyperbaric 0.5% bupivacaine within 10 seconds. The onset of sensory and motor block, the duration of sensory and motor block, and the visual analogue scale (VAS) score were monitored. Results: Data from 100 parturient women were investigated. Even though the median time required for the onset of sensory block to occur was significantly higher in Group S (P = 0.019), the duration of motor block was found to be shorter (P = 0.003); however, the duration of sensory block was similar in both groups (P = 0.771). VAS scores were significantly higher in Group S (P = 0.001). Conclusions: In conclusion, the pregnant women who smoked had longer motor block onset times, shorter motor block durations, higher VAS scores, and lower patient satisfaction levels.

Pregabalin administered as an anxiolytic agent in ultrasound-guided infraclavicular block: a controlled, double-blind, dose-ranging trial.

OBJECTIVE: Adjuvant agents, given with local anesthetics or via venous, oral, or rectal routes for peripheral nerve blocking, have been in use for a long time. Literature studies about pregabalin usage in peripheral nerve blocking are limited in number. In this study, we aimed to reveal the blocking quality of pregabalin administered orally in various doses as an anxiolytic agent and its effective dose range. PATIENTS AND METHODS: Eighty patients who underwent upper extremity bone surgery were included in the study. The cases were divided into 4 randomized groups of 20 patients. The group that did not receive any medication before the surgery was named the Control Group (Group C), the group that received 75 mg pregabalin per os was named Group P75, the group that received 150 mg pregabalin per os was named Group P150, and the group that received 300 mg pregabalin per os was named Group P300. The study had a controlled and double-blind design. Before, during and after routine peripheral nerve blocking, vital signs, Ramsey Sedation Scale, Patient Satisfaction, Visual Analog Scale, and termination durations of sensorial and motor blocks were recorded. RESULTS: Motor block initiation durations of all groups given pregabalin were significantly shorter than those of Group C. Sensorial block termination durations were similar in Group P150 and Group P300, and both were significantly longer than those in Group C and Group P75. First analgesic requirement time for Group P150 and Group P300 were significantly longer than that of Group P75. Although there was no significant difference between postoperative patient satisfaction and VAS values, first analgesic requirement times of the pregabalin administered groups were longer than those of the control group. CONCLUSIONS: The patients, who are about to undergo surgery, generally develop anxiety about death, not waking up from anesthesia, disability, pain and loss of ability to work. Pregabalin is an anti-epileptic, analgesic and anxiolytic agent. With these characteristics, it can be used to reduce pre-operative anxiety, for prophylaxis against convulsions and post-operative analgesia. One hundred fifty mg of pregabalin provides sufficient and effective analgesia, and this dose positively affects the quality of the block.