Percutaneous PRF is an effective treatment option in the NP pain model, and further studies are needed to clarify its underlying mechanisms of action.

IntroductionDespite the high incidence of pulmonary embolism its diagnosis continues to be difficult, primarily because of the vagaries of symptoms and signs in presentation. Conversely, syncope is a relatively easy clinical symptom to detect, but has varied etiologies that lead to a documented cause in only 58% of syncopal events. Syncope as the presenting symptom of pulmonary embolism has proven to be a difficult clinical correlation to make.Case presentationWe present the case of a 26-year-old Caucasian man with pulmonary embolism induced-syncope and review the pathophysiology and diagnostic considerations.ConclusionsPulmonary embolism should be considered in the differential diagnosis of every syncopal event that presents at an emergency department.

Background: In anesthesia practices, the prevention of sympathetic discharge is important. Dexmedetomidine is a sedative with anxiolytic and analgesic effects. However, its effects on hemodynamic response in direct laryngoscopy are not clear. Objectives: This study aimed to compare the effects of dexmedetomidine with well-known premedication agent midazolam. Methods: Intramuscular 0.05mgkg-1 midazolam (GroupM) or intravenous 1 gkg-1 dexmedetomidine (GroupD) was applied to cases who were scheduled for direct laryngoscopy under general anesthesia. Heart Rate and mean arterial pressure (MAP) were measured before premedication and noted down as control values. Preoperative hemodynamic parameters, recovery times and sedation levels of both groups were compared. Results: In the comparison of MAP of the groups at the postintubation 1 st and 5 th min, the values of Group M were significantly higher (p=0.04, p=0.002). Mean postintubation MAP values at the 1 st , 5 th , and 10 th min and mean postextubation MAP values, at the 1 st min of GroupM were significantly higher than the mean control MAP (p=0.001, p=0.003, p=0.008, p=0.002, p=0.008 respectively). Conclusion: Dexmedetomidine premedication is a more effective alternative to midazolam premedication for hemodynamic stabilization and early recovery in direct laryngoscopy operation.

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Background: In anesthesia practices, the prevention of sympathetic discharge is important. Dexmedetomidine is a sedative with anxiolytic and analgesic effects. However, its effects on hemodynamic response in direct laryngoscopy are not clear. Objectives: This study aimed to compare the effects of dexmedetomidine with well-known premedication agent midazolam. Methods: Intramuscular 0.05mgkg-1 midazolam (GroupM) or intravenous 1 gkg-1 dexmedetomidine (GroupD) was applied to cases who were scheduled for direct laryngoscopy under general anesthesia. Heart Rate and mean arterial pressure (MAP) were measured before premedication and noted down as control values. Preoperative hemodynamic parameters, recovery times and sedation levels of both groups were compared. Results: In the comparison of MAP of the groups at the postintubation 1 st and 5 th min, the values of Group M were significantly higher (p=0.04, p=0.002). Mean postintubation MAP values at the 1 st , 5 th , and 10 th min and mean postextubation MAP values, at the 1 st min of GroupM were significantly higher than the mean control MAP (p=0.001, p=0.003, p=0.008, p=0.002, p=0.008 respectively). Conclusion: Dexmedetomidine premedication is a more effective alternative to midazolam premedication for hemodynamic stabilization and early recovery in direct laryngoscopy operation.