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    Comparison of video laryngoscopy and direct laryngoscopy for nasotracheal intubation during pediatric oral surgery: a randomized clinical trial
    (Kuwait Medical Assoc, 2024) Canakci, Ebru; Gultekin, Ahmet; Cebeci, Zubeyir; Coskun, Ilker; Tas, Nilay; Altinbas, Ali
    Objectives: Airway control is a condition that should be evaluated primarily in anesthesia practice in the pediatric age group. Failed or prolonged intubation duration can cause atelectasis and hypoxia in children. The aim of this study was to examine the effects of Macintosh laryngoscopy and McGrath video laryngoscopy (VL) on hemodynamic parameters in pediatric patients who were scheduled to undergo elective oral surgery and required intubation for the application of general anesthesia. Design: Prospective, randomized, single-blind study Setting: Ordu University, Training and Research Hospital, Ordu, Turkey Subjects: Sixty-six patients were divided into two groups. Interventions: According to the procedure used during intubation, direct laryngoscopy (DL) or VL. Main Outcome Measures: The Cormack-Lehane and Mallampati scores, intubation duration, heart rate and mean arterial pressure values were recorded for all the patients. Results: We found that the intubation time in the VL group was shorter than that in the DL group (P=0.024). Magill forceps were significantly less frequently used in the VL group (P<0.001). When the VL and DL groups were compared, significant differences were observed in the heart rate at minute 3 (P=0.014) and minute 5 (P<0.001), systolic blood pressure at minute 3 (P=0.008), and mean arterial pressure at minute 3 and 5 (P=0.004, P=0.002, respectively). Conclusion: Compared with the classic Macintosh laryngoscopy, McGrath video laryngoscope reduces the intubation time, facilitates intubation and reduces the stress response to intubation. We believe that video laryngoscopy devices should be extensively used in anesthesiology practice.
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    Comparison of video laryngoscopy and direct laryngoscopy for nasotracheal intubation during pediatric oral surgery: a randomized clinical trial
    (Kuwait Medical Association, 2024) Canakci, Ebru; Gultekin, Ahmet; Cebeci, Zubeyir; Coskun, Ilker; Tas, Nilay; Altinbas, Ali
    Objectives: Airway control is a condition that should be evaluated primarily in anesthesia practice in the pediatric age group. Failed or prolonged intubation duration can cause atelectasis and hypoxia in children. The aim of this study was to examine the effects of Macintosh laryngoscopy and McGrath video laryngoscopy (VL) on hemodynamic parameters in pediatric patients who were scheduled to undergo elective oral surgery and required intubation for the application of general anesthesia. Design: Prospective, randomized, single-blind study Setting: Ordu University, Training and Research Hospital, Ordu, Turkey Subjects: Sixty-six patients were divided into two groups. Interventions: According to the procedure used during intubation, direct laryngoscopy (DL) or VL. Main Outcome Measures: The Cormack-Lehane and Mallampati scores, intubation duration, heart rate and mean arterial pressure values were recorded for all the patients. Results: We found that the intubation time in the VL group was shorter than that in the DL group (P=0.024). Magill forceps were significantly less frequently used in the VL group (P<0.001). When the VL and DL groups were compared, significant differences were observed in the heart rate at minute 3 (P=0.014) and minute 5 (P<0.001), systolic blood pressure at minute 3 (P=0.008), and mean arterial pressure at minute 3 and 5 (P=0.004, P=0.002, respectively). Conclusion: Compared with the classic Macintosh laryngoscopy, McGrath video laryngoscope reduces the intubation time, facilitates intubation and reduces the stress response to intubation. We believe that video laryngoscopy devices should be extensively used in anesthesiology practice. ClinicalTrials.gov Identifier: NCT04677894. © 2024, Kuwait Medical Association. All rights reserved.
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    Efficacy of ultrasound-guided Transversus Abdominis Plane (TAP) block in inguinal hernia surgery and the immunomodulatory effects of proinflammatory cytokines: prospective, randomized, placebo-controlled study
    (Elsevier Science Inc, 2021) Çanakçı, Ebru; Cihan, Murat; Altinbas, Ali; Cebeci, Zübeyir; Gültekin, Ahmet; Taş, Nilay
    Background: Tumor Necrosis Factor -a (TNF-a) and Interleukin-113 (IL-113) are among the cytokines released secondary to the surgical stress response. The objective of this study was to investigate the effect of a Transversus Abdominis Plane (TAP) block on postoperative pain and its immunomodulatory activity through proinflammatory cytokines. Methods: TAP (study group; n = 40) or p-TAP (placebo group; n = 40). Patients in the TAP group underwent an Ultrasound (US) guided unilateral TAP block using 20-cc 0.5% bupivacaine solution. Patients in the p-TAP group underwent a sham block using 20-cc isotonic solution. The TNF-a and IL-113 levels were measured three times at preoperative hour-0 and postoperative hours 4 and 24. Visual Analog Scale (VAS) scores were recorded at 0-hours, 30-minutes, 4-hours, and 24-hours. Analgesic use within the first 24-hours following surgery was monitored. Results: The postoperative VAS score was decreased in the TAP group at all time points (0, 4, and 24 hours), and the differences between groups were statistically significant (p < 0.001 for all comparisons). In the TAP group, the TNF-a and IL-113 levels at 4 and 24 hours post operation were significantly lower than the preoperative levels (p < 0.001 for all comparisons). Conclusion: The TAP block for pre-emptive analgesia enabled effective hemodynamic control during the intraoperative period, provided effective pain control in the postoperative period, and decreased inflammation and surgical stress due to the decreased levels of the proinflamma-tory cytokines TNF-ec and IL-1 beta in the first postoperative 24 hours, indicating immunomodulatory effect. (c) 2021 Published by Elsevier Editora Ltda. on behalf of Sociedade Brasileira de Anestesiologia. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).