Background: Dexmedetomidine and ketamine popular sedative agents that result in minimal respiratory depression and the presence of analgesic activity. We aimed to compare the effectiveness and safety of a dexmedetomidine-propofol combination and a ketamine-propofol combination during upper gastrointestinal system endoscopy. Methods: The study commenced after receiving approval from the local ethics committee. Patients between 18 and 60 years in the American Society of Anesthesiologists (ASA) I and II groups were included. Patients who had severe organ disease, who had allergies to the study drugs, and who refused to participate were excluded. Cases were randomized into a dexmedetomidine-propofol group (Group D, n = 30) and a ketamine-propofol group (Group K, n = 30). Cardiac monitoring, peripheral oxygen saturation, and bispectral index (BIS) monitoring were performed. Group D received 1 mg/kg dexmedetomidine + 0.5 mg/kg propofol intravenous (IV) bolus, 0.5 μg/kg/h dexmedetomidine + 0.5 mg/kg/h propfol infusion. Group K received 1 mg/kg ketamine + 0.125 mL/kg propofol iv bolus, 0.25 mg/kg/h ketamine + 0.125 mL/kg/h propfol infusion. Patients were followed up with a Ramsay Sedation Scale (RSS) of ≥4. Means, standard deviations, lowest and highest frequency values, and ratio values were used for descriptive statistics, and the SPSS 22.0 program was used for statistical analyses. Results: In Group K, recovery time and mean blood pressure (MBP) values were significantly shorter. Furthermore, coughing rate, pulse, and BIS values were higher than in Group D ( P < .05). Although there were no significant differences between the groups in terms of endoscopic tolerance and endoscopist satisfaction, we observed that the dexmedetomidine group experienced more comfortable levels of sedation. Conclusion: Dexmedetomidine-propofol and ketamine-propofol combinations may be suitable and safe for endoscopy sedation due to their different properties. It was observed that the dexmedetomidine-propfol combination was superior in terms of sedation depth and that the ketamine-propofol combination was superior in terms of early recovery. As a result, we suggest the dexmedetomidine-propofol combination for upper gastrointestinal system endoscopy sedation due to hemodynamic stability and minimal adverse effects.

Background: Congenital heart disease (CHD) is commonly seen in patients with Down syndrome (DS) and is closely associated with morbidity and mortality. Maternal age is an established risk factor for DS. Objectives: The aim of the present study is to analyze the incidence of CHD in Down syndrome and the effect of maternal age on this incidence and the type of CHD. Materials and Methods: Six hundred and thirty-one patients with DS who were admitted to pediatric cardiology department, between December 2014 and December 2018, were retrospectively analyzed. The detected CHDs were evaluated in association with maternal age. Results: Four hundred forty-five (70.5%) cases had one or more congenital heart defect. Two hundred and seven patients (32.8%) had isolated simple defect while the remaining had complex or associated multiple CHDs (n:238, 37.7%). Considering all patients, secundum ASD (42.1%) was the Original Research Article

No abstract

No abstract

myotrofik lateral skleroz (ALS); 5. ve 6. dekadlar arasında başlayan, özellikli bir tedavisi olmayan, 1. ve 2. motor nöronların ilerleyici dejenerasyonu ve ölümüne bağlı oluşan nörolojik bir hastalıktır. Entelektüel yapıda bozulma olmaksızın dil, farinks, larinks ve toraksı da içeren iskelet kaslarında zayıflık ve atrofi gelişir. 1 Bu değişiklikler ALS'li hastalara anestezi uygulamalarında daha dikkatli davranılmasını gerektirir. İleri düzeydeki ALS'lilerde cerrahi işlemler ve anestezi ile ilişkili yayınlar az sayıdadır. Bu hastalarda genel anestezi ile uzamış solunum depresyonu riski söz konusu iken, spinal veya epidural gibi rejyonal anestezi yöntemleri ile de altta yatan hastalığın alevlenme ihtimali bulunmaktadır. 2