1 The aim of this retrospective study was to evaluate etiological and demographical characteristics of acute adult poisoning patients during 1 year at a university hospital in Ankara, Turkey. 2 Two-hundred and twenty-eight adults (of which 180 were suicidal poisoning cases) were admitted to the emergency center with acute poisonings. This was 0.7% of all emergency admissions. The female-to-male ratio was 3: 1, and the majority of patients (63.6%) were below the age of 25 years. 3 Drugs were the major cause in 75.9% of the cases, followed by inhalation of gases (17.6%), food (2.6%), corrosives (2.2%), pesticides (0.9%), and alcohol (0.9%). Analgesics were the most common cause of drug poisoning (29.7% of all substances). There were no fatalities. 4 It is important to realize that this study is a hospital based study, and hence it may be considered difficult to draw conclusions for the whole population of Turkey. However, we consider that the reason for such a high ratio of analgesic poisoning is probably due to the habit of extensive analgesic prescribing in Ankara, which is thecapitalofTurkey.
Sevoflurane and isoflurane preconditioning ameliorates inflammation, cerebral lipid peroxidation, and histologic injury. Downregulation of proapoptotic molecules and upregulation of antiapoptotic molecules may be associated with this effect.
The α 2-agonist dexmedetomidine (Dex), a sedative and analgesic, reduces heart rate (HR) and blood pressure, and has been used in the practice of anesthesia. In this study, we aimed to evaluate the effects of Dex on hemodynamic variables, anesthetic sparing effects, and recovery profiles in patients who underwent surgery in prone position. The prone position itself can cause a decrease in the systemic blood pressure. Forty patients who undergo lumbar discectomy were randomly assigned to receive either Dex (a loading dose 1 μ g/ kg in 10 minutes followed by an infusion rate of 0.2 μ g/ kg/ hr) or saline. In both groups, the anesthesia was induced with fentanyl, thiopental and rocuronium, and maintained with desflurane in 50% N 2 O. Mean arterial blood pressure (MAP), HR, cardiac output (CO), and level of anesthesia were monitored. Recovery times and analgesic requirements were also recorded. As a response to endotracheal intubation, a significant increase in MAP and HR was observed in the control group compared to the Dex group, but no difference in CO. The recovery times were significantly shorter in the Dex group compared to the control group. Anesthetic and analgesic requirements of the Dex group were lower than controls. Thus, the use of Dex caused no detrimental effects on the hemodynamic variables in prone position. In addition, Dex decreased pressure response to intubation, and anesthetic and analgesic requirements, shortened recovery times, and decreased postoperative pain level. Dex may be an alternative to currently used adjunctive anesthetic agents in lumbar discectomy operations.anesthesia; dexmedetomidine; NICO; cardiac output; lumbar discectomy
No surgery is free of complications varying from common minor problems to very unexpected and severe ones. In the case presented here, unilateral paralysis of the muscles of the tongue and ipsilateral vocal cord paralysis due to a lesion of the 10th and 12th cranial nerves occurred following a septorhinoplasty that was performed under endotracheal general anesthesia. This rare entity known as Tapia's Syndrome is believed to be caused by pressure neuropathy of both nerves due to inflation of the cuff within the larynx. We remind surgeons of this unusual complication that can occur in any surgery under general anesthesia and discuss its diagnosis, treatment method, and the followup results in light of the literature.
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