The aim of this study is to review our experience and results of carotid endarterectomy performed under local anesthesia. We evaluated 300 patients who had undergone carotid endarterectomy with local anesthesia in our department. Surgical indication, outcome, operative technique, and complications were assessed. The patients were 58.20+/-2.76 years old and 153 (51%) were symptomatic. The perioperative course was uneventful. A shunt was inserted because of neurological deterioration in 20 patients (6.6%) with full recovery of the deficit after shunt insertion. Operative time was 52.02+/-12.86 min. There were 9 patients with postoperative neurological complications with one patient who died after 34 days. The remaining 8 patients with reversible neurological deficits recovered and were symptom-free on discharge. The mean length of hospital stay was 2.11+/-1.34 days. Carotid endarterectomy performed under local anesthesia is associated with low morbidity and mortality rates. The surgeon can assess the neurological status during the procedure and provide for a more meticulous endarterectomy. It is also associated with decreased shunt usage, decreased operative time and shorter length of hospital stay.

We conclude that increased bitter taste sensitivity correlates with increased intensity or incidence of propofol injection pain and NRS of venepuncture pain.

No abstract

Pregabalin is an antiepileptic, analgesic and anxiolytic drug that GABA analogue with similar structure and actions to gabapentin. There are very few reports about pregabalin intoxication in the literature. A 24-year-old male presented following ingestion of 3 g of pregabalin in this report. He was managed with General Supportive Care and Symptomatic Approach (GSCSA) such as discontinuation of the drug, hydration with IV fluids, oxygenation, gastric lavage and activated charcoal administration and enhanced elimination techniques. But, it is to be noted that either the kidneys of the patients are in good functioning state or there is a hemodialysis facility in the immediate vicinity.

The groups did not differ in age, weight, or height. Levels of progesterone (prelabor group, 147.1 ± 51.6 ng/ mL; and labor group, 160.2 ± 76.4 ng/mL), prolactin (prelabor, 153.8 ± 39.3; and labor, 157.3 ± 36.5 ng/mL), and cortisol (prelabor, 35.4 ± 10.3 mg/dL; and labor, 42.2 ± 17.3 mg/dL) did not differ between groups. Apgar scores and surgical times were similar for the 2 groups. The mean end-tidal concentration of sevoflurane in the prelabor group was higher than the mean concentration in the labor group at all 2.5-minutes time intervals after intubation during anesthesia maintenance. For example, at 10 minutes, the mean ± SD end-tidal sevoflurane concentration was 1.3 ± 0.2 in the prelabor group and 1.1 ± 0.2 in the labor group. Mean BIS values during surgery were 47.6 ± 1.3 and 48.1 ± 1.4, respectively, for the prelabor and labor groups; the groups had similar mean BIS values at all 2.5-minutes periods during surgery. All patients received similar weightadjusted doses of thiopental and no differences in heart rate, noninvasive blood pressure, oxygen saturation, or body temperature were noted between the groups.Although this study found that sevoflurane requirements during general anesthesia for cesarean delivery are decreased in laboring women compared with nonlaboring women, the etiology for decreased anesthetic requirements does not seem to be related to plasma levels of prolactin, progesterone, or cortisol. Additional research is needed to determine the mechanism.