Purpose: Postoperative pain and nausea/vomitting (PNV) are common in laparoscopic cholecystectomy patients. Sympatholytic agents might decrease requirements for intravenous or inhalation anesthetics and opioids. In this study we aimed to analyze effects of esmolol on intraoperative anesthetic-postoperative analgesic requirements, postoperative pain and PNV. Methods: Sixty patients have been included. Propofol, remifentanil and vecuronium were used for induction. Study groups were as follows; I ---Esmolol infusion was added to maintenance anesthetics (propofol and remifentanil), II ---Only propofol and remifentanil was used during maintenance, III ---Esmolol infusion was added to maintenance anesthetics (desflurane and remifentanil), IV ---Only desflurane and remifentanil was used during maintenance. They have been followed up for 24 h for PNV and analgesic requirements. Visual analog scale (VAS) scores for pain was also been evaluated. Results: VAS scores were significantly lowest in group I (p = 0.001---0.028). PNV incidence was significantly lowest in group I (p = 0.026). PNV incidence was also lower in group III compared to group IV (p = 0.032). Analgesic requirements were significantly lower in group I and was lower in group III compared to group IV (p = 0.005). Heart rates were significantly lower in esmolol groups (group I and III) compared to their controls (p = 0.001) however blood pressures were similar in all groups (p = 0.594). Comparison of esmolol groups with controls revealed that there is a significant decrease in anesthetic and opioid requirements (p = 0.024---0.03). Conclusion: Using esmolol during anesthetic maintenance significantly decreases anestheticanalgesic requirements, postoperative pain and PNV.Esmolol; Dor no pós-operatório; Vômito no pós-operatório Efeito da infusão de esmolol sobre a necessidade de anestesia no intraoperatório e analgesia, náusea e vômito no pós-operatório em um grupo de pacientes submetidos à colecistectomia laparoscópica Resumo Objetivo: A dor e a incidência de náusea e vômito no período pós-operatório (NVP) são comuns em pacientes submetidos à colecistectomia laparoscópica. Os agentes simpatolíticos podem diminuir a necessidade de opiáceos ou anestésicos inalatórios ou intravenosos. Neste estudo, nosso objetivo foi analisar os efeitos de esmolol sobre a necessidade de anestésico no período intraoperatório e de analgésico no pós-operatório e a incidência de dor e NVP. Métodos: Sessenta pacientes foram incluídos. Propofol, remifentanil e vecurônio foram usados para a indução. Os grupos de estudo foram os seguintes: grupo I, a infusão de esmolol foi adicionada aos anestésicos (propofol e remifentanil) para manutenção; grupo II, apenas propofol e remifentanil foram usados durante a manutenção; grupo III, a infusão de esmolol foi adicionada aos anestésicos (desflurano e remifentanil) para manutenção; grupo IV, apenas desflurano e remifentanil foram usados durante a manutenção. O período de acompanhamento foi de 24 horas para avaliar a incidência de NVP e a necessidade ...

Using esmolol during anesthetic maintenance significantly decreases anesthetic-analgesic requirements, postoperative pain and PNV.

The significant MEP increases during the prone position under general anesthesia depend on a number of reasons. Among them are inhaler agents, pressure changes in mucosal blood vessels due to venous congestion, and the mastoid bone volume. Further researches are required to determine and explain the mechanisms of increase in MEP during prone position.

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Objective: To compare the postoperative analgesic efficacy and side effects of ultrasound guided-Transversus Abdominis Plane block (USG-TAP) versus laparoscopic-guided Transversus Abdominis Plane block (LAP-TAP) in patients undergoing laparoscopic cholecystectomy. Methods: This randomised, prospective, controlled study included 63 patients aged 18-65 years, classified as ASA I-III, and divided into three groups: Group USG-TAP (n=21) received postoperative TAP block under USG guidance, Group LAP-TAP (n=21) received postoperative laparoscopic-guided TAP block, and Group Control (n=21) received no additional procedure. Visual Analog Scale (VAS) scores and tramadol consumption were used to evalute postoperative pain. Results: The changes in Visual Analog Scale (VAS) scores over time were statistically different in the groups (p=0.002). The change over time was similar in the USG and LAP groups (p=0.221), and the change in the control group was statistically different from that of the other two groups (p<0.05). Conclusion:The analgesic efficacy of USG-guided and laparosopic-guided TAP blocks was found to be similar.