Percutaneous nephrolithotomy (PCNL) is a minimally invasive surgical procedure for renal calculi, and nephrostomy tubes lead to postoperative pain after PCNL. Regional techniques (e.g., epidural analgesia and peripheral blocks) and opioids are applied for postoperative pain treatment. The aim of this study was to compare effectiveness of ultrasound-guided paravertebral block (PVB) and tramadol on postoperative pain in patients who underwent PCNL. Fifty-three patients were included in this prospective randomized study. The patients were allocated into two groups: the PVB group (group P, n = 26) and the tramadol group (group T, n = 27). All patients were administered standard general anaesthesia. Ultrasound-guided PVB was performed at the T11- L1 levels using 0.5% bupivacaine for a total dose of 15 mL in group P. Patients in group T were intravenously administered a loading dose of 1 mg/kg tramadol. Patients in both groups were given patient-controlled analgesia. Haemodynamic parameters, visual analogue scale (VAS) scores, side effects, and complications, tramadol consumption and additional analgesic requirements of the patients were recorded after surgery. Haemodynamic parameters were statistically similar between the groups. The VAS in group P were statistically lower than in group T. In the 24-h period after surgery, total PCA tramadol consumption was statistically lower in group P than in group T. The use of supplemental analgesic in group T was higher than in group P. Ultrasound-guided PVB was found to be an effective analgesia compared to tramadol, and no additional complications were encountered. ClinicalTrials.gov, NCT02412930 , date of registration: March 27, 2015, retrospectively registered.

The trachea and bronchus surgery is generally performed due to stenosis, traumatic injury, foreign body and tumors. Preoperative evaluation and anesthesia management are very important issues because of higher mortality and morbidity rates. Patients may be asymptomatic, but airway difficulties, hypoxia, stridor, cough, hemoptysis are common conditions in these patient population. The collaboration between the surgeon and the anesthesiologist is very substantial and necessary. Anesthetic techniques include various applications such as one lung ventilation, fiberoptic intubation, jet ventilation, and apneic oxygenation, general anesthesia with or without neuromuscular blockade. In this review, anesthesia management of the trachea and bronchus surgery is evaluated in the light of new knowledge.

Background/aim: The modified Yale Preoperative Anxiety Scale (m-YPAS) is widely used to measure children?s anxiety level. The aim of this study was to translate the Turkish version of the m-YPAS and test its validity and reliability based on Turkish children. Materials and methods: The English version of the m-YPAS was translated into Turkish using the forward-back-forward translation technique. This study enrolled 120 children. The m-YPAS was performed on 120 children who were recorded on video. The State- Trait Anxiety Inventory for Children (STAIC) was used for only 30 of 120 children. The videotapes were evaluated by two experienced observers [an anesthesiologist, ObA(an) and psychologist, ObB(ps)]. The interrater reliability, concurrent validity, sensitivity, specificity, positive and negative predictive values were analyzed. Results: The mean age of children was 7.8 ± 2.2 years in the study. The weighted kappa values of the m-YPAS between observers were in `substantial? agreement (?w = 0.74-0.80) and `almost perfect? agreement (?w = 0.84 - 0.85). Also, Cronbach?s alpha values were high [? = 0.85 for ObA(an) and ? = 0.86 for ObB(ps)]. The correlation between m-YPAS and STAIC showed `good? agreement (P < 0.05). The sensitivity and specificity were high, and the predictive value was 92.86%. Conclusion: The Turkish version of the m-YPAS can be performed as a reliable and valid observational questionnaire for Turkish children. Key words: Anxiety, Validation studies, Pediatrics.

Objective: In intensive care unit (ICU) patients, intravenous (iv) and volatile agents are used for sedation. The aim of the present study was to investigate the effects of dexmedetomidine and sevoflurane on pulmonary mechanics in ICU patients with pulmonary disorders. Methods: After approval of the ethical committee and informed consent between the ages of 18-65 years were obtained, 30 patients with an American Society of Anesthesiologist status I-III. who Were mechanically ventilated, who had pulmonary disorders and who needed sedation were included in the study. Exclusion criteria were severe hepatic, pulmonary and renal failures; pregnancy; convulsion and/or seizure history; haemodynamic instability and no indication for sedation. Patients were divided into two groups by randomised numbers generated by a computer. For sedation 0.5%(-10/0) sevoflurane (4-10 mL h(-1)) was used by an Anaesthetic Conserving Device in Group S (n=15), and iv dexmedetomidine infusion (1 mu g(-1) kg(-1) 10 min(-1) loading and 0.2-0.7 mu g(-1) kg(-1) maintenance) was performed in Group D (n=15). Arterial blood gas analysis, airway resistance, positive end expiratory pressure (PEEP), frequency, tidal volume (TV), peak airway pressure (Ppeak), static pulmonary compliance and end-tidal CO2 values were recorded at baseline, 1, 3, 6, 9, 12 and 24 h. Results: Demographic data, airway resistance, PEEP frequency, TV, Ppcak and static pulmonary compliance values were similar between the groups. PaCO2 and end-tidal CO(2)values were higher in Group S than in Group D. Sedation and patient comfort scores were similar between the two groups. Conclusion: Both sevoflurane and dexmedetomidine arc suitable sedative agents in ICU patients with pulmonary diseases.

Objective: To compare the effects of ultrasound-guided thoracic paravertebral block (PVB) and intravenous paracetamol on postoperative pain control in paediatric patients undergoing percutaneous nephrolithotomy (PNL). Methods: Forty patients aged 1-5 years, with an American Society of Anesthesiologists physical status I-II, scheduled for PNL were enrolled into this prospective randomised controlled trial. After arrival in the operating room, all patients were administered standardised general anaesthesia. Patients in Group PVB received ultrasound-guided PVB using bupivacaine 0.5% at a total volume of 0.5 mL kg(-1) at the vertebral levels T11, T12 and L1. Patients in Group P were administered paracetamol intravenously (15 mg kg(-1)) before the beginning of surgery. Patients in both groups were given tramadol (1 mg kg(-1)) for supplemental analgesia. Patient demographics, haemodynamic parameters, peripheral oxygen saturation and sevoflurane concentration were recorded. The Face, Legs, Activity, Cry and Consolability pain scores; satisfaction of parents; the number of patients requiring supplemental analgesia; and complications were evaluated during the postoperative period. Results: Pain scores were significantly lower in Group PVB compared with Group P (p=0.001). There were no analgesic requirements in Group PVB; however, all patients needed a supplemental analgesic in Group P. Parental satisfaction was higher in Group PVB than in Group P. Conclusion: This study demonstrated that ultrasound-guided PVB provides more effective postoperative analgesia with no side effects compared to intravenous paracetamol in children undergoing PNL.

We compared the effects of the laryngeal mask airway (LMA), face mask and Cobra perilaryngeal airway (PLA) in the airway management of spontaneously breathing paediatric patients undergoing elective inguinal surgery. In this study, 90 cases of 1-14-year-old children undergoing elective inguinal surgery were scheduled. The patients were randomly divided into three groups. Anaesthesia was provided with sevoflurane and 50%-50% nitrous oxide and oxygen. After providing an adequate depth of anaesthesia, supraglottic airway devices were inserted in the group I and II patients. The duration and number of insertion, haemodynamic parameters, plateau and peak inspiratory pressure and positive end-expiratory pressure of the patients were recorded preoperatively, after induction and at 5, 10, 15 and 30 min peroperatively. There were no statistical differences between the groups in terms of haemodynamic parameters (p>0.05). In group II, instrumentation success was higher and instrumentation time was shorter than group II. The positive end-expiratory pressure and plateau and peak inspiratory pressure values were statistically lower in group II (p<0.05). We concluded that for airway safety and to avoid possible complications, LMA and Cobra PLA could be alternatives to face mask and that the Cobra PLA provided lower airway pressure and had a faster and more easy placement than LMA.