Background: Sedation has been associated with numerous changes on electroencephalogram (EEG) but there is a need to clarify specific alterations in relation to deepening levels of sedation with different agents. We aimed to evaluate the effect of deepening levels of sedation induced by propofol and how they compare to natural sleep.Methods: Fifty consecutive neurologically normal patients who underwent upper gastrointestinal endoscopy while sedated with propofol were included. Topographic EEG spectral maps and the bispectral index (BIS) values were obtained at four time points: wakefulness, mild sedation, deep sedation and recovery. Observer's Assessment of Alertness and Sedation (OAA/S) score was used to assess sedation levels.Results: Propofol induced increased delta (0.5-3.5 Hz) and gamma (25-40 Hz) power throughout sedation. In addition, there was decreased alpha power (9-11.5 Hz) in the occipital area and increased global beta (12-25 Hz)/gamma (25-40 Hz) power during mild sedation. Deep sedation was associated with increased theta (4-7 Hz)/alpha (9-11.5 Hz)/beta (12-25 Hz) power, which was maximal frontally.Conclusion: There are distinct changes associated with deepening levels of propofol induced sedation that distinguish it from natural sleep. This suggests that different mechanisms are involved in them and warrants further investigations to clarify the nature of these changes.

Sixty women using IUDs were included in two equal groups in the present study. Group I consisted of women presenting with pelvic pain for which they requested removal of the IUD, while the comparison group (group II) requested removal of the IUD for non-medical reasons. After extraction of the IUD, the Wing Sound II device was used to measure uterine cavity length and fundal transverse diameter. The uterine cavity measurements in both groups were not significantly different. When the ratios of IUD dimensions to uterine cavity measurements were compared, it was also found that there were no significant differences between groups. Factors other than discrepancies in size probably contribute to the pathogenesis of IUD-induced pain.

No abstract

Objective: Respiratory dysfunction is a very common postoperative complication that occurs after cardiac surgery. Among the suggested causes is cardiopulmonary bypass. We compared the effect of on-pumpcoronary artery bypass grafting (ONCABG) versus off-pumpcoronary arterybypass grafting (OPCABG) on postoperative respiratory function. Methods:Patients were prospectively divided into two groups ONCABG and OPCABG, (n=100 in each). Respiratory variables (Pao 2 , Paco 2 , Sao 2 , and Pao 2 /Fio 2 ratio) were measured prior to induction of anaesthesia then at seven time points (ICU admission, postoperative hours 1, 3, 6, 12, 18, and 24). Time to extubation, rates of reintubation, and use of noninvasive ventilation (NIV) were also evaluated.Results: Baseline preoperative arterial blood gases and alveolar/arterial oxygen pressure gradients were similar in both groups. Postoperatively, all values were significantly higher in the OPCABG group only at ICU admission (p<0.05). No differences were seen in time to extubation, rate of reintubation rate, and use of postoperative NIV. Conclusion:There is a slightly less incidence of lung injury with OPCABG as compared to ONCABG in low-risk patients especially in the early postoperative period.

No abstract