Background/Aim: Post-operative nausea, vomiting (PONV), and pain are common symptoms after laparoscopic cholecystectomy (LC) that is performed under general anesthesia. These symptoms lead to prolongation of post-operative recovery and hospital stay. In this study, the efficacy of intra-operative methylprednisolone (MP) administration on post-operative pain and PONV was investigated in patients undergoing LC under general anesthesia. Methods: This study was conducted at Uşak University Faculty of Medicine Hospital. Patients who underwent LC under general anesthesia between 01.11.2018 and 01.06.2019 were evaluated using the prospective cohort method. While intra-operative MP was administered to one group of patients who underwent LC (MP group), MP was not administered to the second group (non-MP). The pain was evaluated using the Visual Analog Scale (VAS) while PONV was evaluated with the Verbal Descriptive Scale (VDS in patients at post-operative hours 0, 1, 2, 6, 12, 18, and 24. On the first post-operative day, patient satisfaction was assessed. Results: The study cohort consisted of 76 patients. The VAS was used to measure post-operative pain, and it was discovered that the MP group had significantly reduced VAS values at post-operative hours 0, 1, 2, 6, 12, 18, and 24 (P < 0.001). In the VDS evaluation, no difference between the two groups only at post-operative hour 12 (P = 0.52) was found, while the VDS value was found to be lower in the MP group than in the non-MP group at post-operative hours 0, 1, 2, 6, 18, and 24 (P ˂ 0.001). The mean total analgesic use at post-operative hour 48 was 69.08 (26.91) mg in the MP group and 96.71 (42.38) mg in the non-MP group. The difference was statistically significant (P ˂ 0.001). Conclusion: PONV and discomfort incidence decreased after intra-operative MP administration. The decrease in these symptoms was positively reflected in post-operative patient satisfaction. '+st+' Hill RP, Lubarsky DA, Phillips-Bute B, Fortney T, Creed MR, Glass PS, et al. Cost-effectiveness of prophylactic antiemetic therapy with ondansetron, droperidol, or placebo. Anesthesiology. 2000 Apr;92(4):958-67. DOI: https://doi.org/10.1097/00000542-200004000-00012 Kaya Z, Kaya S, Ölmez G. The effect of granisetron dexamethasone combination on postoperative nausea and vomiting in gynecological operations Dicle Med J. 2010;37(2):109-14. Kranke P, Eberhart LH, Toker H, Roewer N, Wulf H, Kiefer P. A prospective evaluation of the POVOC score for the prediction of postoperative vomiting in children. Anesth Analg. 2007 Dec;105(6):1592-7. DOI: https://doi.org/10.1213/01.ane.0000287816.44124.03 Apfel CC, Heidrich FM, Jukar-Rao S, Jalota L, Hornuss C, Whelan RP, et al. Evidence-based analysis of risk factors for postoperative nausea and vomiting. Br J Anaesth. 2012 Nov;109(5):742-53. DOI: https://doi.org/10.1093/bja/aes276 Fujii Y, Saitoh Y, Tanaka H, Toyooka H. Ramosetron vs granisetron for the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. Can J Anaesth. 1999 Oct;46(10):991–3. DOI: https://doi.org/10.1007/BF03013138 Sun EC, Darnall BD, Baker LC, Mackey S. Incidence of and risk factors for chronic opioid use among opioid-naive patients in the postoperative period. JAMA Intern Med. 2016 Sep; 176(9):1286-93. DOI: https://doi.org/10.1001/jamainternmed.2016.3298 Kelly DJ, Ahmad M, Brull SJ. Preemptive analgesia I: physiological pathways and pharmacological modalities. Can J Anaesth. 2001 Nov; 48(10):1000-10. DOI: https://doi.org/10.1007/BF03016591 Holte K, Kehlet H. Perioperative single-dose glucocorticoid administration: pathophysiologic effects and clinical implications. J Am Coll Surg. 2002 Nov;195(5):694–712. DOI: https://doi.org/10.1016/S1072-7515(02)01491-6 .Rich WM, Abdulhayoglu G, DiSaia PJ. Methylprednisolone as an antiemetic during cancer chemotherapy – a pilot study. Gynecol Oncol. 1980 Apr;9(2):193–8. DOI: https://doi.org/10.1016/0090-8258(80)90027-X Gautam S, Agarwal A, Das PK, Agarwal A, Kumar S, Khuba S. Evaluation of the efficacy of methylprednisolone, etoricoxib and a combination of the two substances to attenuate postoperative pain and PONV in patients undergoing laparoscopic cholecystectomy: a prospective, randomized, placebo-controlled trial. Korean J Pain. 2014 Jul;27(3):278–84. DOI: https://doi.org/10.3344/kjp.2014.27.3.278 Lau H, Brooks DC. Predictive factors for unanticipated admissions after ambulatory laparoscopic cholecystectomy. Arch Surg. 2001 Oct;136(10):1150-3. DOI: https://doi.org/10.1001/archsurg.136.10.1150 Wang JJ, Ho ST, Liu YH, Lee SC, Liu YC, Liao YC, et al. Dexamethasone reduces nausea and vomiting after laparoscopic cholecystectomy. Br J Anaesth. 1999 Nov;83(5):772-5. DOI: https://doi.org/10.1093/bja/83.5.772 Henzi I, Walder B, Tramer MR. Dexamethasone for the prevention of postoperative nausea and vomiting: a quantitative systematic review. Anesth Analg. 2000 Jan;90(1):186–94. DOI: https://doi.org/10.1097/00000539-200001000-00038 Kleif K, Hauge CI, Vilandt J, Gögenur I. Randomized Clinical Trial of Preoperative High-Dose Methylprednisolone on Postoperative Pain at Rest After Laparoscopic Appendectomy. Anesth Analg. 2018 May;26(5):1712-20. DOI: https://doi.org/10.1213/ANE.0000000000002693 Lunn TH, Kristensen BB, Andersen LØ, Husted H, Otte KS, Gaarn-Larsen L, et al. Effect of high-dose preoperative methylprednisolone on pain and recovery after total knee arthroplasty: a randomized, placebo-controlled trial. Br J Anaesth. 2011 Feb;106(2):230–8. DOI: https://doi.org/10.1093/bja/aeq333 Lunn TH, Andersen LØ, Kristensen BB, Husted H, Gaarn-Larsen L, Bandholm T, et al. Effect of high-dose preoperative methylprednisolone on recovery after total hip arthroplasty: a randomized, double-blind, placebo-controlled trial. Br J Anaesth. 2013 Jan;110(1):66–73. DOI: https://doi.org/10.1093/bja/aes345 Aabakke AJ, Holst LB, Jørgensen JC, Secher NJ. The effect of a preoperative single-dose methylprednisolone on postoperative pain after abdominal hysterectomy: a randomized controlled trial. Eur J Obstet Gynecol Reprod Biol. 2014 Sep;180:83–8. DOI: https://doi.org/10.1016/j.ejogrb.2014.06.026 Bashashati M, McCallum RW. Neurochemical mechanisms and pharmacologic strategies in managing nausea and vomiting related to cyclic vomiting syndrome and other gastrointestinal disorders. Eur J Pharmacol. 2014 Jan;722:79-94. DOI: https://doi.org/10.1016/j.ejphar.2013.09.075 Hargreaves KM, Costello A. Glucocorticoids suppress levels of immunoreactive bradykinin in inflamed tissue as evaluated by microdialysis probes. Clin Pharmacol Ther. 1990 Aug;48(2):168–78. DOI: https://doi.org/10.1038/clpt.1990.132 Hong D, Byers MR, Oswald RJ. Dexamethasone treatment reduces sensory neuropeptides and nerve sprouting reactions in injured teeth. Pain 1993 Nov;55(2):171–81. DOI: https://doi.org/10.1016/0304-3959(93)90146-G Waldron NH, Jones CA, Gan TJ, Allen TK, Habib AS. Impact of perioperative dexamethasone on postoperative analgesia and side-effects: systematic review and meta-analysis. Br J Anaesth. 2013 Feb;110(2):191–200. DOI: https://doi.org/10.1093/bja/aes431 Copyright (c) 2022 Ebru Aladağ, Yücel Gültekin This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

The Pericapsular Nerve Group (PENG) block is a novel regional anesthesia technique that provides adequate analgesia while preserving motor function. This cross-sectional study evaluated the quality, reliability, and educational value of YouTube videos on the PENG block. Thirty-six videos were analyzed using validated scoring systems (GQS, JAMA, DISCERN, and modified DISCERN). Overall video quality was moderate, with higher scores observed in procedural and institutional videos. The findings highlight both the educational potential and the need for quality control in online medical content.

Lidocaine, an amide-type local anesthetic, and melatonin, a multifunctional indoleamine with mitochondrial regulatory and anticancer properties, have each been reported to modulate cancer cell survival. However, whether these agents cooperatively promote apoptosis in neuroblastoma cells through transient receptor potential vanilloid 1 (TRPV1)-mediated calcium signaling remains insufficiently defined. This study investigated the individual and combined effects of lidocaine and melatonin on SH-SY5Y human neuroblastoma cells, focusing on TRPV1-dependent intracellular mechanisms. Intracellular Ca² ⁺ responses were assessed using Fura-2-AM fluorescence, while apoptosis, reactive oxygen species (ROS) production, mitochondrial membrane potential (ΔΨm), and caspase-3/caspase-9 activities were evaluated using spectrofluorometric methods. The lidocaine + melatonin combination significantly increased cytosolic Ca² ⁺ levels, ROS production, mitochondrial depolarization, caspase activation, and apoptosis compared with control and single-treatment groups. These responses were attenuated by capsazepine, supporting TRPV1-mediated Ca² ⁺ influx as a central mechanism that appears to drive a Ca² ⁺ –mitochondria–ROS feed-forward axis leading to mitochondrial dysfunction and caspase-dependent apoptosis. These findings suggest that lidocaine and melatonin synergistically promote apoptosis in SH-SY5Y neuroblastoma cells through TRPV1-linked calcium-dependent pathways and provide a mechanistic basis for further investigation of anesthetic–adjunct interactions in translational oncology research.

Maternal death refers to the death of a woman during pregnancy, during delivery, or within 42 days after the termination of pregnancy, and for any reason exaggerated by the pregnancy condition or pregnancy process regardless of the duration and location of the pregnancy. Starting on 11 March 2020 in Turkey, the COVID-19 pandemic resulted in a total of 5,638,178 confirmed cases and 51,048 deaths. Our case aged 24 years was a young mother having severe weight loss since the beginning of pregnancy because of malnutrition due to depression, smoking, and nausea. The weight loss of the patient, who was infected by COVID-19 in a short while after the last visit in family healthcare, became more severe, the general appearance became worse, and she gave preterm birth in the 30th gestational week. The cardiopulmonary arrest occurred during the delivery. Although necessary interventions were made, the patient was lost on the same day. Since it is a rare case, this case is presented together with a literature review. Keywords: COVID-19, pandemics, maternal mortality

Aim: This study compared the guideline adherence, clinical safety, risk stratification, source accuracy, and practical applicability of three commercial large language models in perioperative GLP-1 receptor agonist (GLP-1 RA) and dual GLP-1/glucose-dependent insulinotropic polypeptide receptor agonist (GLP-1/GIP RA) management scenarios.Methods: In this non-interventional scenario-based comparative study, 20 English-language perioperative clinical scenarios were submitted once to ChatGPT Plus, Claude Pro, and Gemini Advanced/Google AI Pro. A total of 60 first complete responses were evaluated. Responses were scored using a predefined 10-point composite scale across five domains and predefined binary quality and safety outcomes. Paired non-parametric analyses were used for model comparisons.Results: ChatGPT achieved uniformly maximal total scores (mean 10.00), followed by Gemini (mean 8.00) and Claude (mean 5.85). Total scores differed significantly across models (χ²(2)=37.333, p

Ketamine has pharmacological actions beyond N-methyl-D-aspartate receptor antagonism, whereas sodium selenite modulates redox-dependent signaling. Transient receptor potential vanilloid 1 (TRPV1) channels regulate Ca²⁺ influx and may contribute to oxidative stress-associated apoptosis. We investigated whether ketamine and sodium selenite, alone and combined, promote apoptosis through TRPV1-associated mechanisms in SH-SY5Y neuroblastoma cells. Cells were assigned to control, ketamine+sodium selenite (Ket+Sel), Ket+Sel+capsazepine (CPZ), ketamine, ketamine+CPZ, sodium selenite, and sodium selenite+CPZ groups. Ketamine (10 µM) and/or sodium selenite (500 nM) were applied for 48 h; CPZ (0.1 mM, 30 min) was used for pharmacological antagonism, and capsaicin (0.1 mM) for stimulation. Intracellular Ca²⁺ responses were assessed using Fura-2-AM, whereas apoptosis, reactive oxygen species production, mitochondrial depolarization, and caspase-3/9 activities were measured spectrophotometrically or fluorometrically. Under capsaicin-stimulated assay conditions, ketamine and sodium selenite increased all endpoints relative to control, and the combined treatment produced the greatest responses for most endpoints. CPZ attenuated Ca²⁺ responses and several downstream oxidative and apoptotic markers. These findings indicate that ketamine and sodium selenite, particularly in combination, enhance apoptosis through a CPZ-sensitive pathway compatible with TRPV1-associated Ca²⁺-ROS-mitochondrial signaling, while not establishing exclusive TRPV1 mediation.