Introduction and Purpose: We compared propofol and ketofol for sedation in patients who underwent shoulder arthroscopy under anesthesia with interscalene and suprascapular blocks. We evaluated both of agents the intraoperative hemodynamic effects, sedation efficiency, postoperative recovery times and the time to discharge to the service. We aimed to achieve an effective sedation with stable hemodynamics, resulting in rapid recovery with early onset. Methodology: The study was carried out prospectively in a double-blind randomized study on ASA I and II patients aged 18-65, total of 42 shoulder surgeries planned. Anesthesia was provided to the patients by performing interscalene and suprascapular nerve block with USG. Group 1 (Propofol group), 1 mg/kg propofol iv, in Group 2 (Ketofol group), a mixture of ketamine-propofol was prepared in a 1:1 ratio, 1 mg / kg ketofol iv was administered. Processing was started in both groups when Ramsey Sedation Scale (RSS) was 3. SBP, DBP, MBP, heart rate, O₂ saturation, RSS, Faces scale were recorded throughout the case. The patients with an Aldrete score of 9 were discharged and sent to the service. Results: A total of 42 patients undergoing planned shoulder surgeries were enrolled. No statistically significant was determined between the groups in respect of demographic data (age, gender, height, weight, ASA), operating time and postoperative length of stay in hospital. More patients required esmolol in the ketofol group compared to propofol group; 15 (71.4%) vs. 7 (33%) patients (p < 0.05). Significant higher mean values of hemodynamic findings in the ketofol group were noted; SBP at 55 min, DBP at 60 min, MBP at 60 min and MBP on discharge (p < 0.05). In the absence of esmolol, the pulse measurements at 0, 1, 3, 25, and 30 min were determined to be statistically significantly higher in the ketofol group than the propofol group (p < 0.05). The mean values of the SpO2 measurements were significantly lower in the ketofol group (p < 0.05). No statistically significant difference was determined in respect of the postoperative modified Aldrete Scores (MAS) at any of the time points (p > 0.05). Conclusion: While a deeper and higher quality sedation was provided with ketofol, we achieved rapid onset and short-acting sedation with propofol. Both agents have different superior properties and can be used safely for sedation. Key words: Brachial plexus block, ketofol, shoulder arthroscopy, propofol, sedation Citation: Akcaalan Y, Sahap M, Gulec H, Horasanli E, Ugurlu M, Akcaalan S. Comparison of propofol and ketofol for sedation in patients undergoing shoulder surgery with interscalene and suprascapular nerve blocks. Anaesth. pain intensive care 2022;26(1):102-109. DOI: 10.35975/apic.v26i1.1775 Received: September 24, 2021, Reviewed: October 18, 2021, Accepted: Nov 09, 2021

Background: Large language models such as ChatGPT are increasingly used by patients seeking perioperative information, yet their reliability for anesthesia-related patient education remains insufficiently evaluated. This study assessed the quality of ChatGPT-4.0 responses to frequently asked anesthesia questions using a multi-rater evaluation framework. Methods: Twenty-two common anesthesia-related patient questions were identified through online search. Each question was submitted once to ChatGPT-4.0 (GPT-4-turbo; chat.openai.com) without follow-up prompts. Five anesthesiology and reanimation specialists—each with more than 20 years of experience—independently evaluated each response using a validated 4-point Likert-type scale (1 = excellent; 4 = unsatisfactory). Inter-rater reliability was calculated using a two-way random-effects model (ICC[2,1]). Results: A total of 110 ratings were collected. Among these, 61.8% were classified as excellent, 32.7% as satisfactory requiring minimal clarification, and 5.5% as satisfactory requiring moderate clarification. No responses were rated as unsatisfactory. Mean scores for individual questions ranged from 1.0 to 2.4. Reviewer-wise averages ranged from 1.27 to 1.73, indicating generally positive evaluations with modest variability in scoring strictness. The overall inter-rater reliability was poor to fair (ICC = 0.25). Conclusions: ChatGPT-4.0 provided high-quality responses to frequently asked patient questions about anesthesia and may serve as a supportive digital health tool for patient education. However, limited agreement among evaluators highlights the need for expert oversight and contextual refinement when integrating large language models into clinical communication pathways.

Background: Dental anxiety is a challenge in pediatric dentistry, often compromising treatment outcomes and oral health. Procedural sedation offers therapeutic benefits, yet insufficient parental knowledge may hinder acceptance. This study aimed to assess parental knowledge and examine associated factors. Methods: A single-center, cross-sectional, 25-item survey was conducted among 176 parents of children scheduled for dental treatment under sedation. The respondents completed questions related to sedation, demographic details, and attitudes towards preventive oral health measures. Categorical data were analyzed using chi-square tests with Monte Carlo simulation–based p-values, with significance set at p < 0.05. Results: 90.9% of participants were mothers with a mean age of 35.4 years. Although 74.4% reported familiarity with dental sedation, only 54.5% was able to distinguish sedation from general anesthesia. Anxiety about sedation was prevalent among 65.9% of parents, and the most frequent concerns were about recovery and respiratory complications (47.7% and 35.2%, respectively). Lower anxiety, pain-free anesthesia experience, preservation of spontaneous breathing, and accurate anesthesia provider information were associated with higher education and income (p < 0.05). A statistically significant relationship was identified between higher-income households and the propensity of parents to report more correctly about sedation, toothbrushing practices (p=0.002), access to preventive services (p

Dental anxiety and hypersensitive gag reflex are common clinical challenges in dentistry and frequently lead to referral for intravenous sedation. Although