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    Comparison of diphenhydramine and lidocaine for prevention of pain after injection of propofol: a double-blind, placebo-controlled, randomized study
    (LIPPINCOTT WILLIAMS & WILKINS, 2007) Apiliogullari, S.; Keles, B.; Apiliogullari, B.; Balasar, M.; Yilmaz, H.; Duman, A.
    Background and objective: Pain on injection is still a problem with propofol. The purpose of the study was to compare the effectiveness of diphenhydramine and lidocaine on pain caused by propofol at the site of injection. Methods: One hundred and eighty ASA I-II adults undergoing elective surgery were randomly assigned into three groups of 60 each. Group I (placebo) received 2 mL normal saline, Group 11 received 2 mL (40 mg) 2% lidocaine and Group III received 2 mL (20 mg) diphenhydramine intravenously (i.v.) during a 1-min venous occlusion, followed by propofol into a cephalic forearm vein of the antecubital fossa. Pain assessment was made immediately after propofol injection. Results: In the placebo group 25 (41.7%) patients experienced pain during propofol injection as compared to 2 (3.3%) and 3 (5.0%) in the lidocaine and diphenhydramine groups, respectively. The prevalence of pain and pain score were significantly less in both the lidocaine and diphenhydramine groups than in the placebo group (P = 0.00). No difference was found between the diphenhydramine and lidocaine groups (P = 0.60). Conclusion: Previous injection of diphenhydramine with venous occlusion can be considered as an alternative to lidocaine for reducing the prevalence of pain caused by injection of propofol into peripheral veins.
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    Evaluation of Neonatal Pneumothorax
    (FIELD HOUSE PUBLISHING LLP, 2011) Apiliogullari, B.; Sunam, G. S.; Ceran, S.; Koc, H.
    Pneumothorax progresses quickly in newborns and can lead to death. This study collected data prospectively over a 2-year period on risk factors, clinical course and prognostic factors of newborn cases diagnosed and treated for pneumothorax. Thirty patients were evaluated for risk factors including concurrent disease, method and duration of chest drainage, oxygen saturation and mechanical ventilation. Pneumothorax developed mostly in male and mature infants during the first 48 h following birth; risk factors included concurrent respiratory distress syndrome and meconium aspiration. Mechanical ventilation was undertaken in 18 (60%) of the patients. Closed-tube drainage was used in 28 (93%) of the patients. Nine out of 10 patients (90%) whose oxygen saturation remained < 90% died. Thus, pneumothorax may develop during the neonatal period, especially in the presence of risk factors, and neonates with < 90% oxygen saturation, despite treatment, have a high mortality rate.