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    Comparison of Spinal and General Anesthesia in Lumbar Disc Surgery
    (Ege University Press, 2012) Kara, İnci; Çelik, Jale Bengü; Öc, Bahar; Apillioğulları, Seza; Karabağlı, Hakan
    Aim: The purpose of this study was to compare the perioperative advantage and disadvantage between general (GA) and spinal anesthesia (SA). Material and Methods: Sixty patients (randomize GA,n=30, SA,n=30) undergoing lumbar disc surgery were enrolled. Patients were matched for demographic data, perioperative physiological changes, pain score, amount of blood loss, surgeon 'satisfaction, perioperative complications and length of stay in hospital. Results: Intraoperatively and postoperatively, the incidence of tachycardia and hypertension were more frequent with GA (p<0.05). The surgeon's satisfaction was reported to be higher in the GA group (p<0.05). Anesthetic and operative times were longer for patients in GA group (p<0.05), in whom more nausea, vomiting, pain and greater requirements for antiemetic and pain medication were also during PACU (p<0.05). 24 hours after surgery, PACU time, ambulation of day of surgery, hospital stay, requirement of antiemetic and analgesic medication, pain score, nausea, urinary retention and headache were similar in two groups (p>0.05), however vomiting was more frequent in GA group in this period (p<0.05). Conclusion: For patients undergoing lumbar disc surgery, spinal anesthesia was as safe and effective as general anesthesia. Specific advantages to spinal anesthesia include decreased antiemetic and analgesic medication and reduced overall complication rate.
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    Palmar Skin Temperature Importance During Transthoracic Endoscopic Sympathectomy for Palmar Hyperhidrosis
    (JOURNAL NEUROLOGICAL SCIENCES, 2012) Öncel, Murat; Sudam, Güven Sadi; Karabağlı, Hakan; Kara, İnci; Çelik, Jale Bengü
    Background: The primary goal of this study is to identity and analysis age, diagnosis, sympathic chain levels, complications and results associated with successful endoscopic surgical treatment for hyperhydrosis and also this study was to investigate of palmar temperature changes during the operation and to prove the successful surgical procedures and beneficial of the bilateral sympathectomy during the peroperative case. Methods: Fifty one patients with severe primary palmar hyperhidrosis received bilateral endoscopic thoracic sympathectomy. Different levels of transection from T4 to T2 were performed step by step until the successful extirpation was implied by the recorded unilateral right palmar temperature intraoperative monitoring. The results of the operations were studied. All patients were followed up and evaluated for symptom resolution, postoperative complication, levels of satisfaction, and severity of compensatory sweating. Effective extirpation ganglia occurred with the intraoperative increasing palmar temperature. Results: Of a total of 102 lateral procedures, 76 laterals (76%) ended the procedure at the T4 level, 23 laterals (23%) ended the procedure at the T3-T5 level, and 1 lateral (1%) ended the procedure at the T2 level. The postoperative complication was minor, and no Horner's syndrome was detected. The rate of symptom resolution was 100% and no recurrence was found. The satisfaction rate was 92%, and the incidence of mild, moderate, and severe compensatory sweating were 12%, 8%, and 6%, respectively. Conclusions: Concerning the sympathectomy for palmar hyperhidrosis, there is a possibility that the level of the transection varies and should be adjusted for each individual patient. Intraoperative monitoring of temperature may be a useful tool in establishing a kind of standardized reference for finding the correct target level.