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    Negative pressure pulmonary edema (NPPE) after discectomy in general anesthesia with endotracheal intubation: Case report
    (2006) Akkurt, B. Cagla O.; Kararmaz, Alper; Inanoglu, Kerem; Serarslan, Yurdal
    Background: Negative-pressure pulmonary edema (NPPE) is a rare and serious complication after general anesthesia. Although it is generally seen after upper airway surgery, it can be seen in different types of surgery also. We report a young, healthy case that developed pulmonary hemorrhage and alveolar edema after extubation of the trachea. Case Report: A 27-year-old ASA II male with a history of smoking, underwent elective discectomy. Following uneventful surgery under general anesthesia, the patient was taken to supine position. He developed a marked inspiratory effort and he bit the endotracheal tube during position changing. Immediately after extubation, the patient developed respiratory distress. Due to desaturation the patient was reintubated An intense hemorrhagic fluid was suctioned in the endotracheal tube. The chest radiograph showed bilateral pulmonary infiltrates. After 24 hours of mechanical ventilation, the patient's symptoms improved and he was extubated. He was discharged from the hospital on the fourth postoperative day. Conclusions: Although it is rare, NPPE can be seen following operations other than upper airway surgery.
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    Periprostatic nerve blockage reduces postoperative analgesic consumption and pain scores of patients undergoing transurethral prostate resection
    (Karger, 2007) Gorur, Sadik; Inanoglu, Kerem; Akkurt, B. Cagla O.; Candan, Yasar; Kiper, Ahmet N.
    Introduction: To evaluate the effects of periprostatic bupivacaine administration on pain control and analgesic consumption after transurethral prostate resection (TURP). Materials and Methods: The study included 40 male patients with benign prostatic hyperplasia who underwent TURP, and they were divided randomly into two groups. All patients were operated under general anesthesia. The study group patients (n = 20) received periprostatic bupivacaine (0.5% 20 ml) injection (group I), and the control patients (n = 20) received only saline (NaCl 0.9% 20 ml) injection (group II). All injections were performed bilaterally into the periprostatic areas immediately after the TURP procedure via the transperineal route. In the postoperative period, all patients (groups I and II) received tramadol using a patient-controlled analgesia device. Postoperative pain was assessed and recorded using the visual analog scale (VAS) at postoperative hours 1, 2, 3, 4, 5, 6, 7, 8, 12, 16, 20, 24, and 48. Total tramadol consumptions and additional analgesic requirements were also recorded and compared between groups. Results: There was no difference in demographic data between the two groups (p > 0.05). VAS scores of the patients at hours 1, 3, 4, 5, 7, 8, and 12 were found to be significantly lower in group I than in group II (p < 0.05). Total tramadol consumption and patient-controlled analgesia demands of groups I and II were 153.5 +/- 8 52.4 vs. 465.0 +/- 55.1 mg and 17.1 +/- 7.7 vs. 77.8 +/- 7.5 mg, respectively (p < 0.001). No side effect was observed regarding bupivacaine injections. Conclusions: Periprostatic bupivacaine administration was a useful and safe method for postoperative pain control and reduced analgesic consumption in patients undergoing TURP. Copyright (c) 2007 S. Karger AG, Basel.