Role of ischemic modified albumin in the early diagnosis of increased intracranial pressure and brain death.

AIM: Increased intracranial pressure following trauma and subsequent possible development of brain death are important factors for morbidity and mortality due to ischemic changes. We aimed to establish the role of ischemic modified albumin (IMA) in the early diagnosis of the process, starting with increased intracranial pressure and ending with brain death. MATERIALS AND METHODS: Eighteen Wistar-Albino rats were divided into three groups; control (CG, n = 6), increased intracranial pressure (ICPG, n = 6), and brain death (BDG, n = 6). Intracranial pressure elevation and brain death were constituted with the inflation of a balloon of a Fogarty catheter in the epidural space. In all three groups, blood samples were drawn before the procedure, and at minutes 150 and 240 for IMA and malondialdehyde (MDA) analysis. RESULTS: Serum IMA levels at 150 and 240 minutes were higher in ICPG than in CG (p < 0.05). IMA levels were similar in ICPG and BDG. Serum MDA levels at 150 and 240 minutes increased in ICPG and BDG groups compared to CG (p < 0.05). MDA levels were similar in ICP and BD groups. CONCLUSION: IMA should be considered as a biochemical parameter in the process starting from increased intracranial pressure elevation and ending at brain death (Tab. 3, Fig. 5, Ref. 31).

The effects of propofol and memantine on erythrocyte deformability.

OBJECTIVE: Propofol is an intravenous general anesthetic with a primary hypnotic effect. Memantine is an NMDA receptor antagonist that has been shown to reverse changes in memory and synaptic plasticity in animal models. This study aims to investigates whether propofol and/or memantine has any effects on erythrocyte deformability. METHODS: 24 Wistar albino rats were divided randomly into four groups. Group P received 150 mg.kg-1 propofol intraperitoneally (ip); Group M received 1 mg.kg-1 memantine (ip); Group PM received 1 mg.kg-1 memantine mg.kg-1 ip 30 minutes before the administration of 150 mg.kg-1 propofol; and the control group (Group C) received saline ip. Euthanasia was performed in all rats by using intraabdominal blood uptake. The heparinized whole blood samples were used to prepare erythrocyte suspensions, from which erythrocyte suspensions were formed with a PBS buffer solution containing 5% htc, and the deformability parameters were measured. RESULTS: Erythrocyte deformability was significantly higher in Groups P, M and PM when compared to the Group C (p = 0.007 and p = 0.001, p <0.0001, respectively); while the erythrocyte deformability indices were similar in groups P, M and PM. CONCLUSION: The administration of propofol and memantine altered the erythrocyte deformability in the rats, which may lead to further problems in microcirculation. The administration of memantine to the propofol-treated rats did not alter the erythrocyte deformability; however the early results should be verified through further experimental and clinical studies (Fig. 1, Ref. 23).

The effects of dexmedetomidine on pulmonary artery pressure in experiment.

AIM: The primary purpose of this study is to assess the effects of dexmedetomidine (DEX) infusion on pulmonary artery pressures (PAP), heart rate (HR), and mean arterial pressure (MAP) in pigs. The secondary purpose is to evaluate whether DEX infusion via the pulmonary artery has any beneficial effect over the peripheral IV route. MATERIALS AND METHODS: Sixteen healthy male pigs (25-35 kg) scheduled for laparoscopy training were used in this study. The animals were randomly allocated into two groups: Group I (n = 9): A loading dose of 1 µg/kg DEX was administered over 10 minutes followed by an infusion of 0.5 µg/kg/hr for one hour via the pulmonary artery catheter. Group II (n = 7): A loading dose of 1 µg/kg DEX was administered over 10 minutes followed by an infusion of 0.5 µg/kg/hr for one hour via the peripheral venous catheter. Mean PAP, HR, MAP, SpO2, and ETCO2 were recorded at 5, 10, 15, 30, 45, and 60 minutes after the initiation of the DEX infusion. RESULTS: Heart rate and MAP were similar in both groups at all time points. Also, neither the HR nor the MAP deviated from the basal values in Groups I and II at any time point. The mean PAP values were similar in Groups I and II, and in Group I, the mean PAP values were similar to Group I's basal value at all time points. However, in Group II, the mean PAP values at 5, 45, and 60 minutes were significantly lower than Group II's basal value (p = 0.023, p = 0.041, p = 0.015, respectively). CONCLUSION: DEX infusion did not elevate the mean PAP and the results from the administration of DEX through the peripheral vein and pulmonary artery were similar (Tab. 3, Ref. 13).

No effect of perianal application of topical anaesthetic on patient comfort during nonsedated flexible sigmoidoscopy: a randomized, placebo-controlled clinical trial.

AIM: A literature review revealed no data on the effects of topical anaesthetic on patient comfort during flexible sigmoidoscopy. We therefore aimed to evaluate this in a randomized manner. METHOD: One hundred and forty-six patients who underwent flexible sigmoidoscopy were randomly allocated to one of three groups. Vaseline (n = 49), 2% lidocaine gel (n = 51) or a cream of 2.5% lidocaine plus 2.5% prilocaine (n = 46) were applied to the patients 30 min before the procedure. Demographic data and haemodynamic monitoring during procedures were recorded. Pain was assessed by visual analogue scale (VAS) and anxiety levels by the State-Trait Anxiety Inventory (STAI-I and STA-II). RESULTS: Median pre-procedural STAI-I scores were 45, 46 and 40.5 and median post-procedural STAI-I scores were 35, 34 and 33.5 for the vaseline, lidocaine, and lidocaine/prilocaine treatments, respectively. There was no statistical difference among the groups in terms of STAI-I and II scores. However, post-procedural STAI-I scores were significantly lower than pre-procedural values in each group (P < 0.001). There was no significant difference in VAS scores among the groups. In all groups there were statistically higher VAS scores during the procedure compared with the pre- and post-procedural scores (P < 0.001). CONCLUSION: Perianal application of topical anaesthetic does not influence patient comfort during sigmoidoscopy.