RESUMO
PURPOSE: The effects of the 5-hydroxytryptamine (5-HT3) receptor antagonists on regional anaesthesia are complex and unclear. The present study was designed to test the hypothesis that granisetron, a selective 5-HT3 receptor antagonist, would decrease the duration of motor block, sensory block, and proprioception in a dose-dependent fashion in a rat model of bupivacaine-induced sciatic nerve blockade. MATERIALS AND METHODS: Thirty-eight male Wistar Albino rats that received unilateral sciatic nerve blocks were randomly divided into five experimental groups. Group B received a perineural of 0.3 ml of bupivacaine alone; Group BG800 received perineural 0.3 ml of bupivacaine and 800 µg of granisetron 10 min later; Group BG1200 received perineural 0.3 ml of bupivacaine and 1200 µg of granisetron 10 min later; Group BG1200IP received a perineural 0.3 ml of bupivacaine and an intraperitoneal injection of 1200 µg of granisetron 10 min later; and Group S was sham operated. A blinded investigator assessed motor, sensory and proprioception function every 10 min until the return of normal function. RESULTS: The medians for recovery times in Group B, Group BG800, Group BG1200, and Group BG1200IP were 105, 64, 85, and 120 min for motor function, respectively; 80, 64, 84, and 104 min for sensory function; 80, 63, 85, and 108 min were calculated for the proprioception function. The time to the return of normal motor, sensory, and proprioception function was not statistically significantly different between the groups (p > 0.05). Motor block did not develop in any of the rats in Group S. CONCLUSIONS: Local and systemic application of granisetron was not significantly decrease the duration of bupivacaine induced motor, sensory, and proprioception block of sciatic nerve in rat.
Assuntos
Anestesia por Condução, Bloqueio Nervoso, Ratos, Masculino, Animais, Bupivacaína/farmacologia, Anestésicos Locais/farmacologia, Granisetron/farmacologia, Ratos Wistar, Nervo IsquiáticoRESUMO
BACKGROUND: The Iowa Satisfaction with Anesthesia Scale (ISAS) is a valid and reliable measurement tool developed to evaluate patient satisfaction with anesthesia care during different surgical interventions. It is adapted to various languages and used in many studies. Considering the satisfaction of the patient with anesthesia applied in surgical procedures, the presence of such a measurement tool is crucial. AIM: From this point of view, the study aimed to evaluate psychometric properties of the ISAS by adapting it to Turkish culture. METHODS: In this study, a descriptive, methodological and cross-sectional design was used. A total of 210 patients who underwent surgery under general or regional anesthesia were in the study. RESULTS: ISAS Turkish version (ISAS-T) shows good reliability which is obvious with a Cronbach's alpha value of 0.80. The correlation levels of the items with the ISAS total score were calculated between .45 and .73. Test-retest reliability was calculated as 0.83. CFA analysis was applied to the one-dimensional 11-item final version of ISAS. The uni-dimensionality of the 11-item scale was confirmed on a Turkish patient sample. The fit indices for the model obtained were calculated as χ2/sd = 2.342, RMSEA = .80, SRMR = .04, CFI = .90, GFI = .92. The fit indices of the model have good and acceptable fit values. CONCLUSION: Based on the psychometric evaluation, ISAS-T is a valid and reliable measurement tool for measuring patient satisfaction with anesthesia applied during different surgical procedures.
Assuntos
Anestesia, Humanos, Psicometria, Reprodutibilidade dos Testes, Estudos Transversais, Inquéritos e QuestionáriosRESUMO
BACKGROUND AND AIM: Trendelenburg positioning (TP) is a common approach used during internal jugular vein (IJV) cannulation. No evidence indicates that TP significantly increases the cross-sectional area (CSA) of the IJV or decreases the overlap between the carotid artery (CA) and the IJV in dialysis patients. The primary aim of this study was to investigate the effects of the TP on the CSA of the right IJV and on its relationship to the CA. METHODS: Thirty-seven consecutive hemodialysis patients older than 18 years of age were enrolled. We measured the CSA of the right IJV and overlap rate (at end-expiration at the level of the cricoid cartilage) between the CA and the IJV in two positions: State 0, table flat (no tilt), with the patient in the supine position; State T, in which the operating table was tilted to 15° of TP. RESULTS: Data were collected for all of the 37 patients enrolled in the study. The change in CSA and overlap between the CA and the IJV from the supine to the TP was not significantly different. The CSA was paradoxically decreased in 11 of 37 patients when changed from State 0 to State T. CONCLUSIONS: TP does not significantly increase the CSA of the right IJV or decrease the overlap between the CA and the IJV in dialysis patients. In fact, in some patients, it reduces the CSA. Therefore, the use of the TP for IJV cannulation in dialysis patients can no longer be supported.
Assuntos
Cateterismo Venoso Central/efeitos adversos, Decúbito Inclinado com Rebaixamento da Cabeça/fisiologia, Veias Jugulares/diagnóstico por imagem, Diálise Renal/efeitos adversos, Idoso, Artérias Carótidas/diagnóstico por imagem, Feminino, Humanos, Masculino, Pessoa de Meia-Idade, UltrassonografiaRESUMO
Ultrasound-guided right internal jugular vein catheterization (RIJV) should be the first choice to decrease the catheter-related complications in high-risk hemodialysis patients. For this procedure, clinicians should identify the optimum positions of the RIJV, including its lower overlap with the carotid artery (CA) and high cross-sectional area of the vein. The aim of this prospective randomized study to evaluate the effects of mild ipsilateral head rotation combined with Trendelenburg position on RIJV cross-sectional area and its relation to the CA in adult patients. Forty ASA I-II patients who were undergoing elective surgery were enrolled for this study. The subjects were asked to remain supine in the 15-20° Trendelenburg position. Two-dimensional ultrasound was then used to measure the degree of overlap between the RIJV and CA, the cross-sectional area of the RIJV. These measurements were compared between head rotation to the >30° left, <30° left, neutral, and <30° right positions. When the head was in the >30° left position, overlap was seen in 38 of 40 patients (95%). As the head was rotated from >30° left to <30° right, the CA-RIJV overlap (from 95% to 57.5%), and the cross-sectional area (from 14.2 mm to 8.7 mm) significantly decreased. In conclusion, when the head was turned to <30° right, the CA-RIJV overlap significantly decreased, and the cross-sectional area also decreased. When clinicians determine the optimal head position before RIJV cannulation, it is important to consider the advantages and disadvantages of the different head positions from >30° left to <30° right.
