Comparison of types 2 and 3 quadratus lumborum muscle blocks : Open inguinal hernia surgery in patients with spinal anesthesia

OBJECTIVE

The efficacy of quadratus lumborum muscle block (QLB) in abdominal surgery is known; however, the efficacy of different QLB types is unclear. The objective of this study was to investigate the effects of ultrasound-guided QLB type 2 and type 3 on postoperative opioid consumption and pain scores in patients undergoing inguinal hernia surgery.

MATERIAL AND METHODS

In this study 60 patients undergoing open inguinal hernia surgery were randomly assigned to 3 groups. Group QLB2 received ultrasound-guided QLB type 2 and group QLB3 received ultrasound-guided QLB type 3 with 0.25% 20 mL bupivacaine. In the control group (group C) no intervention was performed. Postoperative analgesia was performed intravenously with 1000 mg paracetamol every 6 h and patient-controlled analgesia with fentanyl. Postoperative visual analog scale scores (VAS), opioid consumption, and first analgesic requirement time were evaluated.

RESULTS

Fentanyl consumption was significantly higher in group C compared to the other groups at all time intervals (p < 0.05). Fentanyl consumption was significantly higher in group QLB2 compared to QLB3 at the 4-8 h, 8-24 h, and total 24 h. Passive VAS 4h and 8 h, active VAS 4h, 8h, and 12 h were significantly lower in group QLB3 compared to QLB2 (p < 0.05). The first analgesic time was significantly later in group QLB2 compared to group C (280.52 ± 89.20 min and 183.75 ± 42.79 min, respectively) and even later in group QLB3 compared to the other two groups (463.42 ± 142.43 min, p < 0.05).

CONCLUSION

The use of QLB2 and QLB3 decreased postoperative opioid consumption and pain scores in patients undergoing inguinal hernia surgery. Furthermore, QLB3 provided more effective and longer lasting postoperative analgesia and lower opioid consumption compared to QLB2.

Effect of different doses of pregabalin on skeletal muscle ischaemia-reperfusion injury in rats

AIM/INTRODUCTION

Analgesic, anti-inflammatory and anti-apoptotic effects of pregabalin have been shown previously. In this study, we investigated the protective effect of different doses of pregabalin on skeletal muscle IR injury in rats.

MATERIALS AND METHODS

24 rats were randomly divided into 4 groups (Control, Ischaemia-Reperfusion (IR), IR-Pregabalin 50 mg, IR-Pregabalin 200 mg). Following IR, serum Ischemia Modified Albumin (IMA) and tissue Paraoxonase (PON) were studied and gastrocnemius muscle tissue was removed for histopathologic examination.

RESULTS

Interstitial inflammation was higher in the IR group than in the control and Pregabalin 200 mg groups (p = 0.037, p = 0.037, respectively). Congestion was higher in the IR group than in the control, Pregabalin 50 and 200 mg groups (p = 0.001, p = 0.004, p = 0.004, respectively). PON was lower in the IR group than in the Control, Pregabalin 50 and 200 mg groups (p = 0.001, p = 0.007, p = 0.015, respectively). IMA was higher in the IR group than in the Control, Pregabalin 50 and 200 mg groups (p < 0.0001, all).

CONCLUSION

We think that administration of pregabalin, more prominent at 200 mg, can reverse the injury that occurs in the skeletal muscle of IR-induced rats. Pregabalin can be safely used for analgesia in cases of IR (Tab. 2, Fig. 9, Ref. 41).

Effects of intravenous ibuprofen and lornoxicam on erythrocyte deformability in rats undergoing hind limb ischemia reperfusion injury

BACKGROUND AND AIM

Acute hind limb ischemia reperfusion (I/R) injury is a common consequence of abdominal aorta cross‑clamping during aortic surgery. Erythrocyte deformability is affected by I/R process and may lead to increased tissue and organ injury. Lornoxicam and intravenous ibuprofen are becoming commonly used as non-steroidal anti-inflammatory drugs (NSAID) for postoperative analgesia. In this study, we aimed to investigate the effects of lornoxicam (2 mg/kg iv) and intravenous ibuprofen (30 mg/kg iv) on erythrocyte deformability in I/R model in rats.

MATERIALS AND METHODS

Four study groups, each containing 6 Wistar rats were created. Laparotomy was performed in all groups under general anesthesia with ketamine and xylazine. In all groups except sham group, ischemia and reperfusion were achieved by clamping and declamping the infrarenal abdominal aorta for 120 minutes. Rats in Group IR+L received intravenous infusion of lornoxicam (2 mg/kg) while rats in Group IR+I received intravenous infusion of ibubrofen (30 mg/kg) following 2 hours of ischemic period. At the end of reperfusion period, erythrocyte packs were prepared from heparinized blood samples. Erythrocyte suspensions with hematocrit at a concentration of 5% in a phosphate‑buffered saline (PBS) were used in order to perform deformability measurements. The value of p<0.05 was considered statistically significant.

RESULTS

Relative resistance has increased in ischemia reperfusion group when compared to control group (p < 0.0001). Lornoxicam or ibuprofen intravenous treatments did not change the erythrocyte deformability during ischemia reperfusion period in rats (p=0.851, p=0.690).

CONCLUSION

Intravenous ibuprofen or lornoxicam administrations during ischemia reperfusion period in rats have no negative effect on erythrocyte deformability. The findings of the study should be supported with more detailed and extensive clinical/experimental studies in the future (Fig. 1, Ref. 18).

The effects of low and high doses of sugammadex on kidney tissue in streptozotocin-induced diabetic rats

BACKGROUND

Sugammadex is primarily excreted via renal route. We investigated effects of low and high doses of sugammadex (16 mg/kg versus 96 mg/kg) on renal tissue samples of streptozotocin-induced diabetic rats.

MATERIAL AND METHODS

Twenty-four Wistar albino rats were divided into 4 groups. Group C (control - 0.9 % NaCl), Group DC (diabetes control; 55 mg/kg streptozotocin, IP, only), Group DR-16S (diabetes-rocuronium - 16 mg sugammadex, IV.) and Group DR-96S (diabetes- rocuronium - 96 mg sugammadex, IV). Renal tissue histopathological evaluation and antioxidant status (measurements of MDA levels and NO activities) were studied.

RESULTS

Significantly higher levels of all inflammation parameters (inflammation, degeneration/necrosis, tubular dilatation, tubular cell degeneration, dilatation in Bowman's space, tubular hyaline casts, and lymphocyte infiltration) were found in the 96 mg/kg sugammadex group. Higher MDA tissue levels and lower NO activity were found in the 96 mg/kg sugammadex group.

DISCUSSION

We can conclude that high-dose (96 mg/kg) sugammadex administration resulted in significant renal tissue damage in diabetic rats. As a consequence, low doses of sugammadex have to be preferred in diabetic patients (Tab. 2, Fig. 4, Ref. 26).

Photovoltaic properties of Au/beta-carotene/n-Si organic solar cells

Photovoltaic properties of Au/beta-carotene/n-Si organic solar cells characterized by current-voltage and capacitance-voltage measurements have been investigated. The photocurrent in the reverse direction increases with increasing illumination intensity. The I(sc) increases linearly with light intensity. The I(sc) dependence of light intensity follows a power law I(sc) approximately F(alpha). The exponent alpha was found to be 1.38. This indicates a monomolecular recombination in this device. Au/beta-carotene/n-Si organic solar cells give an open-circuit voltage of 0.316 V and a short-circuit current of 2.33 x 10(-4) A at light intensity of 6 W/m(2). The best conversion efficiency for Au/beta-carotene/n-Si solar cells was found to be 23.3% at a light intensity of 6 W/m(2).

A preliminary investigation on boron and metal concentrations of the main drainage channel in Konya-Turkey

In this work, the wastewaters and sediments of the main drainage channel in Konya (Turkey) were collected from three different sampling points and analyzed for metals, including iron, chromium, copper, lead, zinc and nickel by using inductively coupled plasma-atomic emission spectrometry (ICP-AES). It was found that for all sampling points sediment samples show a decrease in concentrations in the order Fe >> Zn > Cr > Ni > Cu > Pb. For all sampling points, heavy metal concentrations in wastewater did not exceed the maximum admissible discharge levels regulated by the Institute of Turkish Standards. However, it was found that boron concentration of wastewaters exceed the safe level for irrigation of farmland.

Absence of the musculocutaneous nerve together with unusual innervation of the median nerve

During routine anatomical dissections, absence of the musculocutaneous nerve was determined in a 58-year-old male cadaver. Moreover, the biceps brachii and brachialis muscles were innervated by two separate branches which divided from the median nerve instead of the musculocutaneous nerve. From a branch that divides from the main trunk of the median nerve at nearly the middle of the arm a motor branch again divided that innervated the brachialis muscle and a sensory branch that conveyed the sense of the lateral part of the forearm. Furthermore, it was found that the brachial artery divided into its terminal branches, the radial and ulnar arteries. We believe that this rare variation of the median nerve will shed light upon surgical procedures involving the median nerve.

Using n-alkanes for identification of oils in domestic wastewaters

The aim of this work was to investigate whether linear aliphatic hydrocarbons had a usable potential for the determination of waste oil in wastewater. For that, n-alkanes analyses of wastewater samples from five sampling points (P1-P5) of the sewage system of Konya-Turkey were carried out by gas chromatographic technique and the parameters of carbon predominance index (ICP), n-C17/n-C18 and unresolved complex mixture (UCM)/n-alkanes ratios were determined. It was found that sampling points P1, P2, and P3, which had ICP values 1.52 +/- 0.04, 1.43 +/- 0.05 and 1.12 +/- 0.05, respectively, were polluted with petroleum hydrocarbons and the aliphatic hydrocarbons detected in the sampling points of P4 and P5, which had ICP values of 0.96 +/- 0.05 and 0.95 +/- 0.03, respectively, were from natural origin. These results were also supported by the parameters of n-C17/n-C18 and UCM/n-alkanes ratios and by the correlation between the parameters of ICP, n-C17/n-C18, UCM/n-alkanes and COD, Pb, Cr for all sampling points.