BackgroundIn this retrospective comparative study, we aimed to compare the effectiveness of fentanyl, midazolam, and a combination of fentanyl and midazolam to prevent etomidate-induced myoclonus.Material/MethodsThis study was performed based on anesthesia records. Depending on the drugs that would be given before the induction of anesthesia with etomidate, the patients were separated into 4 groups: no pretreatment (Group NP), fentanyl 1 μg·kg−1 (Group F), midazolam 0.03 mg·kg−1 (Group M), and midazolam 0.015 mg·kg−1 + fentanyl 0.5 μg·kg−1 (Group FM). Patients who received the same anesthetic procedure were selected: 2 minutes after intravenous injections of the pretreatment drugs, anesthesia is induced with 0.3 mg·kg−1 etomidate injected intravenously over a period of 20–30 seconds. Myoclonic movements are evaluated, which were observed and graded according to clinical severity during the 2 minutes after etomidate injection. The severity of pain due to etomidate injection, mean arterial pressure, heart rate, and adverse effects were also evaluated.ResultsStudy results showed that myoclonus incidence was 85%, 40%, 70%, and 25% in Group NP, Group F, Group M, and Group FM, respectively, and were significantly lower in Group F and Group FM.ConclusionsWe conclude that pretreatment with fentanyl or combination of fentanyl and midazolam was effective in preventing etomidate-induced myoclonus.

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BackgroundHypotension is the most common problem with spinal anesthesia. This prospective study aimed to compare normotensive and hypertensive patients with respect to the hemodynamic effects of spinal anesthesia performed with hyperbaric bupivacaine.Material/MethodsSixty patients who were scheduled to undergo various elective operations under spinal anesthesia were included into the study. The patients were separated into 2 groups: hypertensive patients constituted Group H (n=30) and normotensive patients constituted Group N (n=30). After fluid loading, spinal anesthesia was performed with 3.5 ml 0.5% hyperbaric bupivacaine. Demographic characteristics and incidence of hypotension and bradycardia were compared. Systolic (SBP), diastolic (DBP), and mean blood pressures (MBP) and heart rate (HR) were also compared before and after spinal anesthesia.ResultsThere was no significant difference between the groups with respect to demographic characteristics, maximal height of sensory block, incidences of hypotension and bradycardia, and the amount of fluids infused (p>0.05). In the hypertensive patient group, the SBP, DBP, and MBP values were significantly higher than in the normotensive patient group at all measurement times (p<0.05). Comparison within the groups did not reveal any significant differences in either group compared to the basal values (p>0.05). There were no significant differences in HR between or within groups (p>0.05).ConclusionsThere was no significant difference between normotensive and hypertensive patients in the incidences of hypotension caused by spinal anesthesia with 0.5% hyperbaric bupivacaine.

Objective: In this study, we aimed to evaluate preoperative and postoperative anxiety and effects of anxiety on the postoperative pain and analgesic consumption in nasal septoplasty. Methods: One hundred ninety three volunteered patients completed the Spielberger's State-Trait Anxiety Inventory (STAI-S and T) before the operation. It were recorded the age, gender, education level, settlement place of the patients, previous history of any operation, methods of anaesthesia. It were used the STAI-S to evaluate the anxiety levels and a 10 cm linear VAS (0=none to 10=intolerable) to measure pain levels postoperatively. Postoperative analgesic consumtion were recorded. Results: In this study, we found that STAI-T scores are higher in women. There was no relation between the methods of anaesthesia and the STAI and VAS scores. Postoperative pain and analgesic consumption did not correlate with STAI scores and VAS scores. Conclusion: Preoperative and postoperative anxiety has no effects on the postoperatve pain levels and analgesic consumption in septoplasty as a minor procedure and a outpatient surgery.

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