We tested dexmedetomidine, an alpha2 agonist, for its ability to decrease heart rate, arterial blood pressure, and neuroendocrinal responses to skull-pin head-holder application during craniotomy. In a randomized, double-blinded, placebo-controlled study, 40 patients undergoing craniotomy with attachment of a pin head-holder were randomly assigned to one of 2 equal groups. The placebo group received saline, whereas the treatment group (DEX group) received a single bolus dose of dexmedetomidine (1 microg/kg) intravenously over 10 minutes before induction of anesthesia. Arterial blood pressure, heart rate, and sequential concentrations of circulating cortisol, prolactin, insulin, and blood glucose were measured. Relative to baseline and the other group, arterial blood pressure and heart rate decreased significantly after the administration of dexmedetomidine through skull pinning (P<0.05). In the placebo group, patients' heart rate and arterial blood pressure measures increased at 1 and 5 minutes after skull-pin insertion, compared with baseline and the DEX group (P<0.05). In both groups, plasma cortisol, prolactin, and blood glucose increased significantly relative to baseline after skull-pin insertion. However, the values were significantly higher in the placebo group compared with the DEX group (P<0.05). Although insulin levels were not significantly altered in the DEX group, the plasma concentrations of insulin decreased significantly after pin insertion in the placebo group. Our results suggested that, a single bolus dose of dexmedetomidine before induction of anesthesia attenuated the hemodynamic and neuroendocrinal responses to skull-pin insertion in patients undergoing craniotomy.

BACKGROUND:The aim of this study was to investigate the role of carbohydrate-rich drink (CHO) on perioperative discomfort, hemodynamic changes, and insulin response in patients undergoing surgery with spinal anesthesia.METHODS:Forty-four adult patients were assigned to one of the two groups of 22, namely preparation with CHO (CHO group) or fasting from midnight (control group). Ten different discomfort variables, blood glucose and insulin concentrations, and hemodynamic changes were recorded during the perioperative period.RESULTS:Preparation with CHO was effective in reducing hunger, thirst, malaise, unfitness, and, to some extent, anxiety (p < 0.05). Plasma glucose and insulin concentrations were increased in the CHO group (p < 0.05). Plasma glucose increased and insulin decreased in the control group (p < 0.05). In the control group, mean arterial pressure was lower compared to the CHO group (p < 0.05).CONCLUSIONS:Preparation with CHO before spinal anesthesia is advantageous due to reducing perioperative discomfort, improving insulin response and stabilizing mean arterial pressure.

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : In this study, we investigated a cartilage degradation marker; cross-linked C-terminal telopeptide of collagen, CTX-I (serum) and CTX-II (urine) along with other laboratory variables in postmenopausal women with osteoarthritis (OA) of the knee with/without associated osteoporosis (OP). In addition, we aimed to investigate whether CTX-II which is released into the synovial fluid and systemic circulation and excreted by urine was an effective marker for the diagnosis of OA. th stage of OA groups were 61%+, 80%+, 78%+, 44%,+ 172%+, respectively. C Co on nc cl lu us si io on n: : CTX-II levels of the control group were similar to those of the knee osteoarthritis patients with or without osteoporosis as well as radiologically graded subgroups, and statistical analysis did not show statistically significant differences. , However, percentage change of median values between the control group and group I, II, and between the control group and radiologically 2 nd , 3 th , 4 th stage of OA groups were significant. K Ke ey y W Wo or rd ds s: : Postmenopause; osteoporosis; osteoarthritis, knee; collagen type I trimeric cross-linked peptide Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmada osteoporozun (OP) eşlik ettiği veya etmediği diz osteoartritli (OA) postmenopozal kadınlarda diğer laboratuvar değişkenlerinin yanı sıra kollagen çapraz bağlı C-terminal telopeptidi CTX-I (serum) ve CTX-II (idrar) olarak adlandırılan kıkırdak parçalanma belirtecini araştırdık. Sinovyal sıvı ve sistemik dolaşıma salınan ve idrarla atılan CTX-II'nin OA tanısı için etkili bir belirteç olup olmadığını araştırmayı da amaçladık. Ayrıca CTX-II ile OA'in radyolojik dereceleri arasında olası bir ilişkiyi değerlendirdik. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : OA veya OP öyküsü olmayan postmenopozal kadınlar kontrol grubunu oluşturdu (n=21). Çalışma grubu I primer diz OA olan 30 postmenopozal kadından oluşurken, Grup II OP'nin yanı sıra primer diz OA'sı olan 14 kadından oluşuyordu. Grup I ve Grup II Kellgren-Lawrence sistemine göre evre 2, evre 3 ve evre 4 olarak radyolojik olarak kategorize edildi. B Bu ul lg gu ul la ar r: : Kontrol grubu ve Grup I, II ve radyolojik olarak 2., 3., 4. evre OA grupları arasında özellikler ve yaş, beden kitle indeksi, menopoz süresi ve alkalen fosfataz, eritrosit sedimentasyon hızı, C-reaktif protein, osteokalsin, CTX-I ve CTX-II düzeyleri gibi hasta verileri bakımından istatistiksel olarak anlamlı fark bulmadık. Kontrol ve evre gruplarının CTX-II değerleri (ng/mmol) sonuçları aşağıdaki gibiydi: Ortanca olarak sırasıyla (25-75): 341 (216-850); 609,34 (363-1072); 492 (319-927); 928 (400-1245); (p=0,210). Kontrol grubu ve grup I, II ve radyolojik olarak 2., 3., 4. evre OA grupları arasında ortanca değerlerin yüzde değişimi sırasıyla %61+, %80+, %78+, %44+, %172+ idi. S So on nu uç ç: : Osteoporozu olan ve olmayan diz osteoartriti hastaların ve radyolojik olarak derecelendirilmiş alt grupların CTX-II düzeyleri kontrol grubuna göre istatistiksel olarak anlamlı...