Thyroid surgery may cause severe postoperative pain and discomfort for patients. Superficial cervical plexus block (SCPB) is one of the regional anesthesia techniques that can provide postoperative analgesia for thyroid surgery. The purpose of this study was to evaluate analgesic effect of ultrasound (US) guided SCPB in patients undergoing thyroid surgery. Fifty ASA I-II patients, aged 20-60, were included in this single blinded study. In a randomized and prospective manner patients were allocated to either SCPB or control group. Bilateral SCPB was performed preoperatively under US guidance using 10 ml 0.25 % bupivacaine for each side. Postoperative analgesia was provided with patient-controlled analgesia method with morphine intravenous. Primary outcome measure was postoperative opioid consumption and analyzed using Mann-Whitney U test. Secondary outcome measures were comparison of opioid side effects like nausea and vomiting and analyzed using Chi square test. VAS scores for pain at postoperative 1st, 6th, 12th, and 24th h were similar in SCPB and control groups (Median VAS values were 2.5, 3, 2, 0 and 3.5, 3, 2, 0 respectively). Postoperative morphine consumption was lower in SCPB group compared to control group at postoperative 6th, 12th, and 24th h (Median doses of morphine consumption were 4, 8, 9 and 5, 9, 11 mg respectively) (P < 0.05). Eight patients in the control group and six patients in the SCBP group had vomiting. Seven patients in the SCPB and none in the control group had hoarseness. Our study has shown that US guided SCPB has a significant analgesic effect in patients undergoing thyroid surgery. Further studies are required to search for the optimal LA dose during US guided SCPB.
Background/aim: Different techniques exist for the preoxygenation of patients that will be operated on under general anesthesia. Preoxygenation with the deep breath (DB) method may affect cardiovascular stability, which is crucial for coronary artery bypass graft (CABG) patients. In this study, we aimed to compare the effects of the 3 min TVB preoxygenation technique and 1 min 8DBs technique on hemodynamic response and arterial oxygenation in patients with normal ejection fraction that were scheduled for elective CABG surgery.Materials and methods: Forty patients classified as ASA II-III and scheduled for elective CABG surgery were randomly assigned to TVB/3 min or 8DBs/1 min for preoxygenation. Cardiovascular variables, i.e. heart rate, mean arterial pressure, central venous pressure, cardiac index, systemic vascular resistance index, and stroke volume index, and arterial blood gas samples were analyzed before and after preoxygenation and at the end of the apneic period before intubation. Results:The preoxygenation methods affected the hemodynamic response similarly. PaO2 increased significantly with 8DBs compared to the TVB at the end of preoxygenation but was similar between the groups at the end of the apneic period (respectively, P: 0.03; P: 0.15). PaCO2 changes were similar between the groups. Conclusion:In patients with normal ejection fraction scheduled for CABG, 8DBs can be an alternative to TVB preoxygenation. Our results should be compared with those of other studies.
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