High thoracic epidural anesthesia in patients with synchronous carotid endarterectomy and off-pump coronary artery revascularization.

Background/aim: In order to reduce the risk of cerebrovascular insults (CVI), the latest recommendations suggest that carotid endarterectomy (CEA) is strongly indicated in patients scheduled for coronary surgery when significant carotid artery stenosis is symptomatic and/or bilateral. The best results are obtained in small studies with CEA performed immediately prior to off-pump coronary bypass (OPCAB). We present 16 consecutive patients who underwent synchronous CEA and OPCAB under general anesthesia combined with high thoracic epidural anesthesia (TEA) in order to evaluate the safety and potential benefits of such anesthetic management.

Combined spinal-epidural technique: single-space vs double distant space technique.

Background/aim: Several combined spinal-epidural (CSE) anesthesia techniques have been described. This study was designed to compare the single space ("needle-through-needle") technique (SST) and the double distant space technique (DDS) with regards to the time needed for the procedure, patient discomfort during the procedure and patient's preference technique.

Methods: This prospective, randomized single-blind study included 156 patients undergoing colorectal surgery under general anesthesia and CSE.

Comparison of analgesic effect of intrathecal morphine alone or in combination with bupivacaine and fentanyl in patients undergoing total gastrectomy: a prospective randomized, double blind clinical trial.

Background/aim: Combined spinal-epidural-general anesthesia has several advantages over general anesthesia alone. This study was designed to compare the efficacy of intrathecal (IT) morphine alone, or in combination with bupivacaine and fentanyl, as part of a combined spinal-epidural (CSE) analgesia, in patients undergoing elective total gastrectomy.

Methods: This prospective, randomized double-blind study included 60 patients undergoing total gastrectomy under general anesthesia and CSE.

Blood transfusion in cardiac surgery--does the choice of anesthesia or type of surgery matter?

Background/aim: In spite of the evidence suggesting a significant morbidity associated with blood transfusions, the use of blood and blood products remain high in cardiac surgery. To successfully minimize the need for blood transfusion, a systematic approach is needed. The aim of this study was to investigate the influence of different anesthetic techniques, general vs combine epidural and general anesthesia, as well as different surgery strategies, on-pump vs off-pump, on postoperative bleeding complications and the need for blood transfusions during perioperative period.

[Impact of hyaluronidase on anesthetic distribution in retrobulbar region following sub-Tenon anesthesia].

Background/aim: Sub-Tenon's block is nowadays commonly used in ophthalmic surgery because of its safety and efficacy. The aim of this study was to investigate the distribution of the anaesthetic solution with different amounts of hyaluronidase in the retrobulbar space, following an injection into the Sub-Tenon's space.

Methods: In this experimental study, 40 pig cadaver heads were used (80 eyeballs).

Sacrospinous ligament fixation for neovaginal prolapse prevention in male-to-female surgery.

Objectives: To report our experiences of vaginal sacrospinous ligament fixation after vaginoplasty in male transsexual patients with the aim of preventing its postoperative prolapse.

Methods: From August 1997 through November 2005, a total of 62 male transsexual patients (mean age 26 years, range 18 to 58) underwent sacrospinous ligament fixation for neovaginal prolapse during male-to-female sex reassignment surgery. The neovagina was created from a penile skin tube flap combined with a urethral flap.

[Influence of perioperative administration of amino acids on thermoregulation response in patients underwent colorectal surgical procedures].

Background: Hypothermia in the surgical patients can be the consequence of long duration of surgical intervention, general anesthesia and low temperature in operating room. Postoperative hypothermia contributes to a number of postoperative complications such as arrythmia, myocardial ischemia, hypertension, bleeding, wound infection, coagulopathy, prolonged effect of muscle relaxants. External heating procedures are used to prevent this condition, but some investigations reported that infusion of aminoacids during surgery can induce thermogenesis and prevent postoperative hypothermia.

Immune cytokine response in combat casualties: blast or explosive trauma with or without secondary sepsis.

The aim of this study was to assess the prognostic value of tumor necrosis factor (TNF) alpha, interleukin (IL)-8, IL-4, and IL-10 in combat casualties. Fifty-six casualties with severe trauma (blast and explosive) who developed sepsis and 20 casualties with the same severity of trauma without sepsis were enrolled in this study. Fifty-five casualties developed multiple organ dysfunction syndrome; 36 died.

Longitudinal dorsal dartos flap for prevention of fistula after a Snodgrass hypospadias procedure.

Objectives: The Snodgrass technique presents the procedure of choice for distal hypospadias. Fistula formation is the most common complication with various rates. We evaluated the importance of a urethral covering using vascularized dorsal subcutaneous tissue for fistula prevention.

[Endophthalmitis in war and peace penetrating eye injuries].

Background/aim: Nowadays, eye injuries are a leading cause of one-eye disease or blindness worldwide. The aim of this study was to comparatively analyze the frequency of endophthalmitis following war and peace eye injuries.

Methods: All the patients went throught the detailed ophthalmologic examinations, prophylactic antibiotic treatment, and pars plana vitrectomies (VPP), or other required surgical interventions.