Fascia iliaca compartment block (FICB) is one of the regional techniques applied for post-operative pain control after femoral and knee surgery. To the best of our knowledge, there are limited reports focusing on local anesthetic (LA) volume. Our aim in this study was to find the most clinically effective volume by comparing three different volumes of LA used frequently in the literature for US-guided infra-inguinal FICB for post-operative pain control in patients undergoing femur and knee surgery. A total of 45 patients with ASA I-III physical scores were included in the study. When the surgical procedure was completed under general anesthesia, FIKB was applied with 0.25% Bupivacaine under ultrasound guidance to the patients before extubation. Patients were randomly divided into three different groups for the volume of local anesthetic to be administered. Bupivacaine was administered 0.3 mL/kg in Group 1, 0.4 mL/kg in Group 2 and 0.5 mL/kg in Group 3. After FIKB, the patients were extubated. The patients were followed up for 24 h postoperatively in terms of vital signs, pain scores, additional analgesic requirement, and possible side effects. When the post-operative pain scores were compared, the scores of Group 1 were found to be statistically higher than Group 3 at the post-operative 1^st, 4^th, and 6^th h (p<0.05). When the additional analgesia requirement compared, the post-operative 4^th h was highest in Group 1 compared to the other groups (p=0.03). At the post-operative 6th h, additional analgesic requirement was less in Group 3 than in the other groups, and there was no difference between Groups 1 and 2 (p=0.026). As the LA volume increased, the amount of analgesic consumed in the first 24 h decreased, but there was no statistically significant difference (p=0.051). Our study showed that ultrasound-guided FIKB is a safe and effective method for post-operative pain relief as a part of multimodal analgesic components, and 0.25% bupivacaine in 0.5 mL/kg volume provides more effective analgesia than the other two groups without any side effects.

Background: The aim of this study was to compare the total fluid volume performed by noninvasive Pleth Variability Index in thoracic surgery patients in comparison to conventional fluid management Methods: In this prospective randomized controlled study conducted between May 2019 and May 2020, 80 patients (68 males, 12 females; mean age: 58.5±6.7 years; range, 18 to 65 years) were divided into two groups: control (Group C) and the Pleth Variability Index (Group P). After performing routine anesthesia and Pleth Variability Index monitoring for all patients, fluids were given at a rate of 2 mL/kg/h with the standard anesthesia technique. Additional fluid supplementation was provided based on hemodynamic data in Group C. In Group P, 250 mL bolus crystalloid fluid was provided when Pleth Variability Index was >14%. Mean arterial pressure, heart rate, oxygen saturation, arterial blood gas, and blood biochemistry were recorded. Total fluid volumes and urinary output were also recorded. Results: There was no significant difference between the groups in terms of total fluid volumes or urinary output. In the postoperative period, the oxygen saturation and mean arterial pressure of Group P were found to be higher than those of Group C. The postoperative creatinine and lactate values of Group P were lower than those of Group C. Conclusion: Although there was no significant difference in the total fluid given to the patients, fluid management by Pleth Variability Index monitoring had a positive effect on mean arterial pressure, oxygen saturation, lactate, and creatinine levels.

Ambulatory surgery has been increasingly performing in our country. We had discussed our results in our ambulatory surgery clinic during eight months period. All patients underwent ambulatory surgery in our clinic from 4th January 2007 to 31th August 2007 enrolled in this study. Preoperative, peroperative and postoperative results were reviewed retrospectively for all patients. Patients demographic data, departments performed surgery, operations, duration of surgery, ASA classification, anesthesia methods and applied medicines, intra- and postoperative complications, postoperative recovery time from anesthesia, discharge ratio and times were all evaluated.In our outpatient surgery clinic,.since 4th January 2007, 1542 patients had been operated. While %67.83 of all patients were ASA I, %21.27 of all patients were ASA II and %10.24 of all patients were ASA III. The most common operations were excision of mass and biopsy applications. The most frequently used type of anaesthesia was local anesthesia. The most common regional technic was spinal anesthesia. Postoperative mean recovery time from anesthesia was 27.07±13.98minutes. Thanks to advances in surgery and anesthesiology, a lot of anesthesia techniques could be performed safely with proper patient and anesthesiologic techniques selection in ambulatory clinics.

OBJECTIVES: To compare proseal laryngeal mask airway (PLMA) with an endotracheal tube (ET) for airway safety, maintained ease of insertion, and hemodynamic stability in pediatric strabismus surgery (PSS). METHODS: This prospective-randomized clinical study was carried out in the Department of Anesthesiology, Faculty of Medicine, Gaziantep University, Turkey between April 2008 and July 2009. Eighty American Society of Anesthesiology (ASA) I-II children, weight 10-30 kg, aged between 1-12 years undergoing PSS were selected. The anesthesia was induced with 8% sevoflurane, 50% nitrous oxide/oxygen mixture, and a neuromuscular blockade with 0.5 mg/kg atracurium in both groups. After a sufficient dosage of anesthesia, the patients were randomized into 2 groups (Group P: PLMA, n= 40, Group T: ET, n=40) and an airway management device; either a PLMA or ET was inserted. The number of placement attempts, placement success or failure, success or failure of a gastric suction tube placement during the procedures and perioperative complications were assessed. RESULTS: Thirty-eight patients (95%) in the PLMA group, 39 (97.5%) patients in the ET group were successfully placed with a PLMA and ET on the first attempt (p>0.05). There were no statistically significant differences in the hemodynamic parameters, end-tidal carbon dioxide, and complications. CONCLUSIONS: This study revealed that PLMA may offer an alternative airway to ET wherein positive pressure ventilation was the preferred choice for children undergoing PSS.

Objectives: Tinnitus, defined as the perception of sound without an external stimulus, is a complex condition with unclear etiology. Emerging evidence suggests a link between vascular dysfunction, particularly arterial stiffness, and tinnitus. This study aimed to evaluate vertebral artery stiffness in patients with idiopathic subjective tinnitus and assess the utility of Doppler ultrasonography as a non-invasive diagnostic tool. Materials and Methods: In this prospective study, 31 patients with idiopathic tinnitus (11 males, 20 females; mean age: 50.42 ± 9.64 years) and 24 healthy controls (12 males, 12 females; mean age: 39.67 ± 10.63 years) underwent comprehensive clinical evaluations, including pure tone audiometry, blood tests, and vertebrobasilar Doppler ultrasonography. Vertebral artery stiffness index (VAS), resistive index (RI), and pulsatility index (PI) were measured bilaterally. Results: A total of 31 patients with idiopathic subjective tinnitus and 24 healthy controls were evaluated. The mean age was significantly higher in the tinnitus group compared to controls (50.42 ± 9.64 vs. 39.67 ± 10.63 years, p < 0.001). Lipid profile analysis revealed significantly higher levels of total cholesterol (193.6 ± 47.28 vs. 167.5 ± 28.99 mg/dL, p = 0.021), LDL (149.4 ± 37.9 vs. 106.1 ± 10.7 mg/dL, p < 0.005), and triglycerides (202.2 ± 83.5 vs. 148.6 ± 26.4 mg/dL, p < 0.005) in tinnitus patients. Doppler ultrasonography demonstrated significantly higher vertebral artery stiffness values in the tinnitus group (left: 2.87 ± 0.72 vs. 2.12 ± 0.22; right: 2.99 ± 0.77 vs. 2.14 ± 0.5; both p < 0.005). Similarly, pulsatility index (PI) was significantly elevated in patients compared to controls (left: 2.45 ± 1.2 vs. 1.2 ± 0.43; right: 2.49 ± 1.02 vs. 1.19 ± 0.42; both p < 0.005). No significant differences were observed in resistive index (RI) or vertebral artery diameters between groups. Among tinnitus patients, PI and VAS were significantly higher on the side corresponding to reported tinnitus symptoms (p < 0.05), suggesting a lateralized vascular contribution. Conclusions: The findings suggested a potential relationship between idiopathic subjective tinnitus and vertebral artery stiffness. We demonstrated the utility of Doppler ultrasonography, a cost-effective and non-invasive imaging modality, for evaluating vascular parameters in tinnitus patients, paving the way for broader clinical applications. By uncovering a significant association between vertebral artery stiffness and tinnitus, our findings suggest that vascular health assessments could enhance diagnostic and therapeutic strategies for tinnitus management.