Bispectral-Index-measured sevoflurane requirement might be decreased in individuals with major depressive disorder.

BACKGROUND: GABA (γ-aminobutyric acid) is the primary inhibitory neurotransmitter in the CNS and well-known target for general anesthetics. In addition, the dysregulation of GABA could be involved in the etiology of major depressive disorder (MDD). In this study, we aimed to determine whether MDD has any effect on anesthetic requirement measured by Bispectral Index (BIS). METHODS: This study was designed as a prospective, observational study, registered ANZCTR (ACTRN 12616001295437), with institutional review board approval and written informed consent. Inpatients who were planned to undergo laparoscopic cholecystectomy as an elective surgery, were enrolled in this study. Patients were divided into two groups, based on the results of the Beck Depression Inventory (BDI) which was assessed the 21-item self-administered scale measuring various symptoms of depression. If the BDI score was under 10, it was accepted as control group. Patients were consulted to the psychiatrist if the BDI score was 17 or more. Patients who were diagnosed as MDD by the psychiatrist, were classified as MDD group. Anesthesia was standardized, and delivered sevoflurane concentration was adjusted according to BIS value in both groups. Parameters of the study were heart rate, non-invasive arterial blood pressure, arterial oxygen saturation, BIS, end-tidal carbon dioxide, and end-tidal concentration of sevoflurane at 5-minute intervals during the operation. RESULTS: End-tidal concentration of sevoflurane was found to be lower in MDD group during the maintenance phase of anesthesia. Mean end-tidal concentration of sevoflurane were significantly lower in MDD group (1.28±0.15) than control group (1.52±0.22) (P<0.0001). BIS values were lower at 5- and 10-minute intervals in MDD group in comparison with control group. BIS values were similar at other time intervals in both groups during surgery. CONCLUSIONS: MDD might result in decreased end-tidal concentration of sevoflurane. Further study is required to identify the relationship between MDD and anesthetics.

[Postoperative analgesic effect of acupuncture in laparoscopic cholecystectomy surgery]. / Laparoskopik kolesistektomi operasyonlarinda akupunktur uygulamasinin ameliyat sonrasi analjeziye etkisi.

OBJECTIVES: In surgery clinics, postoperative pain is a common occurrence and care is needed in its treatment. One form of treatment is various acupuncture techniques. This study investigated the effect of acupuncture on postoperative analgesia in patients undergoing laparoscopic cholecystectomy. METHODS: A total of 59 patients undergoing laparoscopic cholecystectomy were included in the study; 31 comprised the acupuncture group (Group A), and 29 constituted the control group (group C). All patients underwent standard anesthesia procedures. Patient-controlled analgesia with tramadol was administered postoperatively. Patients' postoperative pain scores, results of the satisfaction questionnaire and amounts of tramadol used were recorded. Postoperative 0, 1st, 2nd, 6th, 12th and 18th hour controls were performed. RESULTS: A comparison of the groups showed Group A pain scores to be significantly lower statistically than those of Group C at all postoperative controls. There was no statistically significant difference for postoperative analgesic consumption and satisfaction level between the groups. CONCLUSION: Despite detection of a reduction in postoperative pain scores, the application of acupuncture did not cause any change in the consumption of tramadol.