In the literature, it has been suggested that ketamine-related oxidative organ damage results from increased blood adrenaline level, and thiopental-related oxidative damage is caused by decreased adrenaline level, suggesting that ketamine-thiopental combination (KT) may be beneficial in reducing the hepatotoxic effect of ketamine. To biochemically investigate the effects of ketamine, thiopental and KT on the liver in rats. Male albino Wistar type rats received intraperitoneally (ip.) 30 mg/kg ketamine in the ketamine alone (KG) group (n = 6), 15 mg/kg thiopental in the thiopental alone (TG) group (n = 6), and 30 mg/kg ketamine + 15 mg/kg thiopental in the ketamine+thiopental (KTG) group (n = 6). The same volume of distilled water as solvent was given to the healthy (HG) animal group. This procedure was repeated once daily for 30 days. At the end of this period, the animals were killed by decapitation and their livers were removed. In liver tissue, malondialdehyde (MDA), total glutathione (tGSH), total oxidant status (TOS), total antioxidant status (TAS), tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1β), and interleukin-6 (IL-6) levels were measured. The IL-1β, IL-6, TNF-α, adrenalin (ADR), noradrenalin (NDR), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels were determined in blood samples taken from the tail veins. In the group treated with ketamine and thiopental alone, MDA, TOS, IL-1β, IL-6, TNF-α, ADR, NDR, ALT, and AST levels were found to be high, and those of tGSH and TAS to be low. However, there was no significant change in the levels of these parameters in the KTG. These results indicate that oxidative stress and inflammation developed in the liver tissue of the group that used ketamine and thiopental alone, suggesting that the KT form may be safer in terms of toxicity in the clinical usage.

We aimed to investigate the preventive effects of carvacrol against ketamine-induced cardiotoxicity biochemically and histopathologically in an experimental model.The rats were divided into three g...

In this experimental study we aimed to investigate the biochemical and histopathological effects of concomitantly administered taxifolin on tramadol-induced liver damage in rats. The rats were divided into three groups; control group (CG), tramadol alone (TRG), and taxifolin + tramadol given (TTRG) groups. Malondialdehyde (MDA), total glutathione (tGSH), total oxidant status (TOS), total antioxidant status (TAS), nuclear factor-kappa beta (NF-kB), tumor necrosis factor-α (TNF-α), and interleukin-1β (IL-1β) levels were measured in liver tissues. Liver tissues were also examined histopathologically. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities were determined in blood samples. In tissue analyses, determinants of oxidative stress and inflammation, all were significantly higher in the TRG group compared with the control and TTRG groups. In the TTRG group, all oxidative stress and inflammation markers were significantly lower than in the TRG group. In addition, there was not any significant difference between the control and TTRG groups regarding the TOS and TAS status. Serum liver enzymes were also significantly higher in the TRG group than in the other two groups. In histopathological examinations, the control group had a normal histological appearance. Degenerative-necrotic hepatocytes and hemorrhage, which were seen at a severe level in the TRG group, were found to be moderate in the treated TTRG group. In addition, mononuclear cell infiltrations were found to be severe in the TRG group and mild in the treated TTRG group. Finally it was concluded that Taxifolin alleviated the toxic effects of tramadol on the liver including the histopathological and biochemical changes as well as the oxidative damage.

Background/Objectives: Following total knee arthroplasty (TKA), adductor canal block (ACB) is usually used for postoperative analgesia; however, the optimal injection level is yet unclear. This study tried to determine how the injection level of the ACB had an impact on postoperative analgesic efficacy and functional results after total knee arthroplasty. Methods: A total of 108 patients undergoing unilateral total knee arthroplasty under spinal anesthesia were included in this prospective observational study and were categorized according to the level of ultrasound-guided adductor canal block performed (proximal [Group I], mid [Group II], or distal [Group III]). The visual analog scale (VAS) was used to measure postoperative pain at 1, 4, 8, 12, and 24 h. Additionally, functional pain throughout 24-h standardized static and dynamic tests was assessed. We noted 24-h opioid consumption, motor strength levels, and sensory and motor block features. Results: During each time point, the distal group’s VAS scores were considerably higher than those of the proximal and mid groups (e.g., 8th hour: 40.69 ± 10.50 vs. 26.94 ± 8.72 and 23.47 ± 7.64, p < 0.001), whereas there was no difference between the proximal and mid groups (p > 0.05). At 24 h, the distal group had significantly higher functional pain scores on all dynamic and static measures (p < 0.001). The proximal and mid groups had longer sensory block durations (5.38 ± 1.33 and 5.03 ± 1.29 h) than the distal group (2.95 ± 0.95 h, p < 0.001). While mid-level ACB maintained motor function, 13.9% of patients receiving proximal ACB experienced transient motor block. Conclusions: After TKA, injection level has a major impact on postoperative analgesia. Mid-level ACB supports the employment of multimodal analgesia techniques by offering the best possible compromise between efficient pain management and motor function maintenance.

Background/Objectives: Shortened clear-fluid fasting is increasingly supported in pediatric anesthesia, yet its combined effects on child-centered perioperative outcomes, family satisfaction, metabolic response, and gastric ultrasonography findings remain unclear. This study evaluated the associations of two routine preoperative fasting practices with preoperative anxiety, perioperative blood glucose, hemodynamic parameters, family satisfaction, and gastric ultrasonography findings in children undergoing elective surgery. Methods: This prospective, two-arm, observational cohort study included 66 children aged 3–12 years with American Society of Anesthesiologists (ASA) physical status I–II scheduled for elective adenotonsillectomy under general anesthesia, following either standard overnight fasting or 5 mL/kg carbohydrate-containing clear apple juice approximately 2 h before surgery. Preoperative anxiety was assessed using the Modified Yale Preoperative Anxiety Scale; blood glucose, hemodynamic parameters, gastric antral cross-sectional area, estimated gastric residual volume, Perlas classification, family satisfaction, fasting duration, and nausea and vomiting were also evaluated. Results: Preoperative anxiety scores were significantly lower in the clear-fluid group than in the overnight fasting group (39.95 ± 20.02 vs. 51.88 ± 22.05; p = 0.003). No significant differences were observed between groups in blood glucose, gastric antral cross-sectional area, estimated gastric residual volume, or Perlas scores. Family satisfaction was significantly higher in the clear-fluid group (8.76 ± 1.66 vs. 4.12 ± 2.00; p < 0.001), and fasting duration was markedly shorter. No perioperative pulmonary aspiration occurred. Conclusions: Administration of 5 mL/kg of carbohydrate-containing clear fluid approximately 2 h before surgery was associated with lower preoperative anxiety and higher family satisfaction, with no significant between-group difference in gastric residual volume.