Introduction: Low molecular weight heparin (LMWH) is used as anticoagulant in diseases characterized by possible thrombosis, as well as for thromboprophylaxis in surgery. The administration of LMWH preoperatively and postoperatively allows satisfactory thromboprophylaxis of patients undergoing surgery. Their application can reduce the number of platelets. Aim: To determine what effect Reviparin has on platelet values postoperatively in patients undergoing open cholecystectomy. Methods: The study was conducted at the Clinic for Anesthesia and Resuscitation of the Clinical Center of the University of Sarajevo. A retrospective study was performed that included data analysis for 33 patients undergoing open cholecystectomy over a two-year period. There were 22 male and 11 female patients out of a total of 33 patients. Platelet values from laboratory findings of patient's medical history were monitored for 5 days. The values found were recorded in a table containing the patient's first and last name, gender, age and platelet value. All patients had the same endotracheal anesthesia with Propofol, Fentanyl, and Atracurium supplemented with oxygen and nitric oxide at the appropriate dose. All of the patients received same dose of 0.25ml (1432 IU) Reviparin (Clivarin) from Abbott GmbH & Co.KG, preoperatively and postoperatively. Patients undergoing laparoscopic surgery as well as patients receiving other low-molecular-weight heparin or receiving higher doses of Reviparin were excluded from the study. Statistical analysis was performed using the MedCalc v12.7 statistical package for biomedical research. Results: An analysis of gender representation in the total sample shows that there was 22 or 66.7% of males while there was 11 or 33.3% of female patients. Analysis of platelet values indicates that there is no statistically significant correlation with gender, but that there is a statistically significant correlation between platelet values between samples, ie. that patients who had higher preoperative values retained more platelet values even during postoperative measurements. Conclusion: Platelet values do not change significantly postoperatively with the use of prophylactic doses of Reviparin, after an open cholecystectomy.

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Introduction. Brachialis plexus block is a frequently used method of regional anesthesia that can be performed in several ways and locations. It has been successfully performed to provide good anesthesia and analgesia lasting several hours for operative procedures on hands. It can be performed by paresthesia technique or by ultrasound that has almost pushed out the old conventional technique since it allows the visualization of the blockade performance. Target. In the paper we use our sample to try to determine which of the two locations of the blockageis more favorable for the patient, and which one gives a higher percentage of success or a better sensory blockade. Method. This is a retrospective study and includes 40 patients of both sexes that were operated on at the Clinic for Traumatology and the Clinic for Plastic Surgery of the University Clinical Center in Sarajevo in the period from 30 August 1993 to 30 August 1994. Patients were divided into two groups. Group I were patients who had an axillary approach to plexus brachialis (n-21) ASA I-II. Group II were patients who had supraclavicular access to plexus brachialis (n-19) ASA I-II. All patients received 0.5 ml / kg Bupivacaine 0.5%. In the study, we analyzed sex, age, duration of blockade and complications. Analgesia and motor block were evaluated 20 minutes after the local anesthetic injection. The complete block is defined as analgesia in all dermatomes (C5-Th1) 20 minutes after injection. The results. Group I had 20 male and 1 female patients while group II had 17 male and 2 female patients. The supraclavicular block enabled complete blockade in 18 patients (95.23%), and the axillary approach had a successful blockade in 17 patients (80.95%). In both groups the corresponding motor block was similar. The start of the engine block was similar in both groups. There were no significant complications in either group. Conclusion. Regarding clinical efficacy, both brachial plexus blocking approaches provided a good motor block, anesthesia and analgesia for the forearm or hand surgery. Supraclavicular approach proved to be more favorable.

<p><strong>Aim<br /></strong> To demonstrate the analgesic effect of preemptively administered tramadol and metamizole on the postoperative pain severity, after an elective operative hysterectomy with adnexectomy. <br /><strong>Methods<br /></strong> There were three groups with 30 patients in each group. Patients included in the study were between 45 to 67 years old. They were all in the ASA group II. Randomization was performed in random order according to the regular elective operating program. Patients in Group I received i. m. tramadol 1mg/kg, and in Group II 30mg/kg of metamizole, five minutes before anaesthesia induction. Patients did not receive preemptive analgesia in Group III (control). All patients underwent the same induction anaesthesiology procedure with propofol, fentanyl, tracrium, supplemented with O2, N2O, and sevoflurane at an appropriate dose until MAC 1 was reached. Surgeries lasted for 80-120 minutes. Every patient performed a resting pain assessment 30 minutes after an extubation by Numerical Pain Scale (NPS). <br /><strong>Results<br /></strong>We found out that tramadol had a better effect in preemptive analgesia and that the average pain score for Group I was 6.10 (p=0.043). In Group II, it was 7.93 (p=0.022). There is significant difference in pain intensity between patients in the control group, (pain intensity was 9.16), and those who received tramadol and metamizole. There was no significant difference in the intensity of pain when using these two analgesics (p=0.733). <br /><strong>Conclusion <br /></strong>The effect of preemptively administered tramadol prior to the introduction of general anaesthesia in postoperative pain is significantly more favourable than the effect of metamizole.</p>