Long-Term Pulmonary Histopathologic Changes in Rats Following Acute Experimental Exposure to Chlorine Gas

In this study, we aimed to investigate the long-term histopathologic changes in the lungs of rats exposed to a high concentration of chlorine gas. Twenty-four Sprague-Dawley rats were divided into three groups: the control group (group I) (n = 8), early-examined group (group II) (n = 8), and late-examined group (group III) (n = 8). In group II the lungs of rats were taken out just after the exposure, whereas in group III the lungs were taken out 45 days after the exposure. Eosinophilic liquid accumulation in alveoli and bronchi, diffuse intraalveolar edema, vascular congestion, severe perivascular edema, and free bleeding in intraalveolar and interstitial area were observed in the lungs of rats in group II. Interstitial fibrosis and thickening of the alveolar septa were observed in group III. These findings suggest that the people using these cleaning agents are at risk of harming themselves, and the victims of chlorine gas injury should be reexamined at a later period since they may have pulmonary damage even after 45 days of exposure.

Effects of dexmedetomidine infusion in patients undergoing functional endoscopic sinus surgery under local anaesthesia

BACKGROUND AND OBJECTIVES

Functional endoscopic sinus surgery can be performed under either local or general anaesthesia. The objective of this study was to investigate the haemodynamic effects of perioperatively administered dexmedetomidine, a new generation alpha-2-agonist, in patients for functional endoscopic sinus surgery.

METHODS

Sixty-two patients who were planned to undergo functional endoscopic sinus surgery under local anaesthesia were included in the study. Following meperidine premedication, both groups were monitored in a standard manner with electrocardiogram, non-invasive blood pressure and percentages of peripheral saturation of oxygen. Saline intravenous infusion was started in the placebo group, and dexmedetomidine bolus intravenous infusion (an initial loading dose of 1 microg kg-1 given for a 10-min period followed by 0.7 microg kg-1 h-1) was administered to the treatment group. Maintenance dose infusion was stopped 15 min before the end of the surgical procedure.

RESULTS

Systolic, diastolic and mean arterial pressures, and heart rate markedly decreased in the dexmedetomidine group. However, dexmedetomidine had no effect on serum nitric oxide levels, measured by a nitric oxide/ozone chemiluminescence method. No significant difference was found in oxygen saturation levels of the two groups. Postoperative nausea and vomiting rates were significantly lower in the dexmedetomidine group. No adverse effects were observed with this alpha-2-agonist. Dexmedetomidine provided appropriate levels of sedation.

CONCLUSION

These results suggest that dexmedetomidine provides analgesia, adequate sedation and surgical comfort without adverse effects for patients undergoing functional endoscopic sinus surgery under local anaesthesia.

Low flow desflurane and sevoflurane anaesthesia in children

BACKGROUND AND OBJECTIVE

Low flow desflurane and sevoflurane anaesthesia were administered to children and compared for haemodynamic response, renal and hepatic function, recovery time and postoperative nausea and vomiting.

METHODS

Eighty ASA I-II patients aged 5-15 yr were included in the study. Midazolam was given for premedication. Anaesthesia induction was performed with fentanyl, propofol and atracurium. After intubation, the first group received desflurane, oxygen and nitrous oxide at 6 L min(-1) and the second sevoflurane, oxygen and nitrous oxide at 6L min(-1). Ten minutes after induction the flow was decreased to 1 L min(-1) in both groups. Haemodynamic parameters, preoperative and postoperative renal and hepatic function, the times of operation and anaesthesia, and early recovery data were recorded. Modified Aldrete scores were noted at the 10th and 30th minutes postoperatively and postoperative nausea, and vomiting were assessed.

RESULTS

There were no significant differences in haemodynamic parameters, renal and hepatic functions, postoperative recovery and postoperative nausea and vomiting between groups. The recovery time was shorter in the desflurane group compared to the sevoflurane group.

CONCLUSION

Low flow desflurane and sevoflurane anaesthesia do not adversely affect haemodynamic parameters, hepatic and renal function in children. Desflurane may be preferred when early recovery from anaesthesia is warranted.

Postoperative patient-controlled analgesia with intravenous tramadol, intravenous fentanyl, epidural tramadol and epidural ropivacaine+fentanyl combination

PURPOSE

The aim of this study was to compare the effects of IV tramadol, IV fentanyl, epidural tramadol, and an epidural ropivacaine+fentanyl combination in patient-controlled analgesia (PCA) after lower abdominal surgery.

METHODS

Eighty adult patients undergoing lower abdominal surgery were randomly allocated to one of four groups to receive analgesics with PCA pumps. Patients in group I received IV tramadol, group II patients IV fentanyl, group III patients epidural tramadol, and group IV patients an epidural infusion of 0.125% ropivacaine + 2 microg ml(-1) fentanyl combination. Analgesic effectiveness and side-effects were assessed at 1, 2, 3, 4, 5, 6, 8, 12, 16, 20, and 24 hours after surgery.

RESULTS

Adequate analgesia was achieved in all groups. The analgesia was highest in group IV (p < 0.05), and lowest in group III patients (p < 0.05). Eleven patients (55%) in group I and eight patients (40%) in group II suffered from nausea/vomiting.

CONCLUSION

Although adequate pain relief was achieved with all regimens that were used in the study, intravenous tramadol and intravenous fentanyl are associated with a high incidence of nausea and vomiting.