Background and Objectives: In coronary artery bypass grafting (CABG) surgeries, monitoring intracranial pressure (ICP) is crucial due to neurological risks. Although pulsatile flow (PF) during cardiopulmonary bypass (CPB) is considered more physiological than non-pulsatile flow (NPF), its impact on ICP remains unclear. This study aimed to compare preoperative and postoperative optic nerve sheath diameter (ONSD) measurements between PF and NPF techniques to evaluate their effect on ICP changes. Materials and Methods: Sixty patients undergoing elective CABG (aged 45–75 years, ASA II-III-IV) were enrolled and divided into two groups depending on the cardiopulmonary bypass technique determined by the surgeon: PF (Group P, n = 30) and NPF (Group NP, n = 30). ONSD measurements were performed with ultrasound before surgery (Tpreop) and after surgery (Tpostop). Hemodynamic parameters and jugular and carotid vessel diameters were also recorded. Statistical analysis included t-tests, Mann–Whitney U-tests, chi-square tests, and Pearson correlation. Results: Both groups demonstrated significant increases in ONSD postoperatively compared to preoperative values (p < 0.001). However, no statistically significant difference in the magnitude of ONSD change was observed between the PF and NPF groups (p > 0.05). Group P showed lower ejection fractions and higher total inotrope requirements compared to Group NP (p < 0.01), but these factors did not translate into differences in postoperative ICP dynamics. Conclusions: ONSD measurements increased significantly after CABG surgery, regardless of perfusion type. PF and NPF strategies were comparable in terms of their effects on ICP as reflected by ONSD changes. ONSD ultrasonography appears to be a simple, rapid, and non-invasive tool for perioperative ICP monitoring in cardiac surgery. Further studies are needed to confirm these findings with dynamic intraoperative monitoring and neurocognitive assessments.

Amaç: Laboratuvar parametreleri koronavirüs hastalığı-2019’un (COVID-19) şiddet ve mortalitesini ön görebilir. Pnömoni teşhisiyle iki yoğun bakım ünitesinde tedavi edilen hastalarda ilk kabulde ve 72 saat sonra elde edilen laboratuvar bulguları ile mortalite ve morbidite arasındaki ilişkiyi inceledik. Gereç ve Yöntem: Toplam 75 hastanın kayıtlarından (Mart-Mayıs 2020) gelen bilgiler geriye dönük incelendi. Hasta özellikleri ve laboratuvar parametreleri COVID-19 ve mortalite varlığına göre karşılaştırıldı. COVID-19+ olan hastalar, mortalite ve cinsiyete göre de karşılaştırıldı. Bulgular: Ortalama yaş 74,7±11,3 yıl idi. COVID-19 pozitifliği laboratuvar değerlerinde belirgin değişikliklerle ikişkili değildi. Akciğer hastalığı, yatağa bağımlılık, kötü böbrek fonksiyon skorları ve yüksek C-reaktif protein eks hastalarda daha yaygın idi (p

Backgrounds: Approximately 18 million individuals were diagnosed with cancer in 2018. The rate is predicted to exceed 22 million by 2030. Radiotherapy is an essential part of cancer therapy, with well documented local and systemic side effects, including oxidative stress and apoptosis. Kidney tissues are also exposed to the deleterious effects of radiotherapy, resulting in acute or chronic kidney function impairment. This study compared the effects of the potent selective α2-adrenoreceptor agonist dexmedetomidine and amifostine on oxidative stress and apoptosis in kidney damage induced by x-irradiation in rats. Methods: Forty Sprague Dawley rats were assigned into five groups: control, x-irradiation, x-irradiation + amifostine, x-irradiation + dexmedetomidine 100 µg/kg, and X-ray irradiation + dexmedetomidine 200 µg/kg. Results: Necrotic tubules and degenerative Bowman’s capsules were present in the x-irradiation group. An increase was determined in malondialdehyde (MDA), Cleaved Caspase-3, and 8-OHdG levels compared to the control group (p ≤ 0.05). In contrast, there was a decrease in necrotic tubules, degenerative Bowman’s capsules, and the levels of MDA, Cleaved Caspase-3, and 8-OHdG in the amifostine and dexmedetomidine 100 µg/kg and 200 µg/kg treatment groups (p ≤ 0.05). Conclusions: Alpha 2 adrenergic receptor agonists exhibit protective effects against kidney injury induced in association with x-irradiation by reducing oxidative stress and apoptosis.

The aim of this study was to analyse the effects of minimal-and high-flow anaesthesia on cerebral oxygenation during septorhinoplasty with controlled hypotension using near-infrared spectroscopy. Eighty patients scheduled for septorhinoplasty under general anaesthesia with controlled hypotension were randomised into two groups: minimal-flow (MF) or high-flow (HF). Both groups received desflurane anaesthesia to maintain bispectral index values at 40%-50% and 0.25-0.5 μg kg-1 min-1 i.v. remifentanyl infusion to maintain mean arterial blood pressure between 55 and 65 mmHg. The MF group received 5 L min-1 of fresh gas flow for the first 10 mins then the gas flow was reduced 0.4 L min-1. The HF group received 2 L min-1 of fresh gas flow throughout. Haemodynamic parameters and cerebral oxygen saturation were measured. There were no statistical differences in demographic variables, duration of anaesthesia and surgery, time to extubation and proceeding to an Aldrete score of 9. There were no statistical differences in haemodynamic parameters, end-tidal CO2 and cerebral oxygen saturation. The amount of desflurane used in the MF group was significantly lower than that used in the HF group (30.5±9.8 mL vs. 48.5±12.1 mL; p<0.05). MF and HF anaesthesia did not lead to any difference in cerebral oxygen saturation in patients undergoing septorhinoplasty with controlled hypotension. MF anaesthesia may thus be used as safely as HF anaesthesia is.

Objective We aimed to investigate the effects of hypotensive anesthesia on oxidative stress with serum thiol/disulfide balance in patients undergoing elective septoplasty procedures under general anesthesia. Methods Seventy-two patients between the ages of 18-60, with a physical condition I –II, according to the American Society of Anesthesiologists, were included in this prospective observational study. Septoplasty was chosen for standard surgical stress. According to the maintenance of anesthesia, patients were divided into the groups as Hypotensive Anesthesia (n = 40) and Normotensive Anesthesia (n = 32). Serum thiol/disulfide levels were measured by the method developed by Erel & Neşelioğlu. Results The native thiol and total thiol values of both groups measured at the 60^th minute intraoperatively were significantly lower than the preoperative values (both p < 0.01). Intraoperatively, at the 60^th minute, there was no significant difference in terms of post-native thiol and post-total thiol levels between hypotensive and normotensive anesthesia groups (p = 0.68, and p = 0.81, respectively). Age > 40 years and female gender were found to have a significant effect on dynamic oxidative stress (p = 0.002, and p = 0.001, respectively). Conclusion This pilot study has found that hypotensive anesthesia had no adverse effect on dynamic thiol/disulfide balance in elective surgeries.