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    Immediate cardiac arrest after neostigmine administration
    (2012) Tüfek A.; Yildirim B.; Tokgöz O.; Karaman H.; Aycan l.O.
    Many drugs used in anaesthesia have some potential fatal consequences; for example complete heart block and QTc interval prolongation. Since the parasympathetic system in children is not fully developed, electrical transmission of the heart is not stable. Neostigmine is used in order to reverse neuromuscular block but it may also lead to prolongation of Q-Tc interval. We present a case of an 18-month-old male patient weighing 12kg subjected to a surgical operation because of congenital glaucoma. In order to reverse neuromuscular block at the end of operation, atropine and neostigmine were injected intravenously. However, cardiac arrest developed immediately after administration.
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    Öğe
    The usage of low-dose lidocaine fentanyl in intravenous regional anesthesia
    (2013) Guzel A.; Çelik F.; Uludag O.; Dogan E.; Alemdar C.; Yildirim B.
    We aimed to present our IVRA practices by adding low-dose lidocaine fentanyl for the patients who have undergone forearm and hand surgery. After approval Ethics Committee and the permission of patients, 36 patients which were undergone elective, forearm or hand surgery, aged 18-60 years, were included in the study. The intravenous route was opened with 20 G cannula from the hand back (dorsum) which will operated and double-cuffed pneumatic tourniquet was inserted into the arm proximal. The arm was uplift for ten minutes and had veins drained by firmly wrapping the arm from finger tips towards shoulder to distal arm with the Esmarch bandage. First, the proximal cuff was inflated so as to be 150 mmHg more than systolic pressure. The distal cuff was lowered and the Esmarch bandage was removed. The 100 mg lidocaine+100 ?g fentanyl from the IV cannula on the hand back which will be operated, was given in 40 ml and the distal cuff was inflated after 5 min then proximal cuff was put out. The sensory block was assessed and sensory block initial time and motor block initial time was recorded. The regression times of sensory and motor block were recorded. Also the complications during and after the operation were recorded. Duration of surgery was determined as 30.3±10.1 min and the duration of tourniquet was 41.3±9.1 min. Sensory block initial time was recorded as 8.1±2.6 min, and the time for sensory block regression was recorded as 6.2±3.1 min. The motor block initial time was recorded as 13.4±5.2 min and motor regression time was recorded as 5.6±2.8 min. The clinical diagnoses of the patients were shown in Table 2. According to the VAS scores, it was observed that adequate level of anesthesia and analgesia was maintained for all patients. The addition of low-dose lidocaine to fentanyl in IVRA may provide both sufficient and effective anesthesia and decrease the complications related with local anesthetic toxicity.