Conclusion Milrinone inhalation facilitated the weaning from CPB as it significantly reduced mPAP and maintained MAP with subsequently less needs for vasoactive drugs. © Copyright 2020 by Turkish Anaesthesiology and Intensive Care Society.Objective Bone marrow aspiration and lumbar puncture play essential roles in the diagnosis and treatment of haematological disorders. These repeated invasive procedures lead to considerable pain and stress in children, which is emotionally stressful for their parents. This study aimed to compare the effectiveness and outcomes of two combinations of midazolam-ketamine (MK) and propofol-sufentanil (PS) in painful procedures of children with haematologic malignancy. https://www.selleckchem.com/products/ew-7197.html Methods In this prospective, randomised, double-blind clinical trial, we enrolled 80 eligible patients with haematologic malignancy aged 2-14 years. We randomly allocated them to the MK and PS groups. We recorded and compared the level of sedation, pain severity, hemodynamic indices, the onset of effect, duration of recovery and complications during and after procedure in the two groups. We analysed the data using the SPSS software. We used Mann-Whitney U, independent t-test, chi-square and Fisher's exact tests to compare continuous and categorical variables. Results From initially enrolled patients, 68 patients completed the study (38 in PS and 30 in MK group). The levels of sedation and the mean score of pain intensity were significantly lower in the MK group than those in the PS group (p less then 0.05). Movements and the needs to repeat the dose were significantly lower in the MK group than those in the PS group (p less then 0.05). Conclusion During bone marrow aspiration and lumbar puncture procedures in children with haematologic malignancy, the findings of this trial suggest that MK combination therapy provides better sedation and analgesia than PS. © Copyright 2020 by Turkish Anaesthesiology and Intensive Care Society.Objective The objective of the present study was to determine whether or not the effects of peripheral nerve block can be reversed by flushing normal saline down a peripheral nerve block catheter following the completion of arteriovenous (AV) fistula surgery. Methods In the present study, 38 patients undergoing AV fistula surgery were recruited, and a brachial plexus block with a peripheral nerve catheter was established. Following surgery, the patients were randomised to either the control group or the washout group, where 10 mL of normal saline was flushed down the peripheral nerve catheter at 15-minute intervals for 1 h while the patients were in the postoperative recovery room. An observer blinded to the patient group allocation assessed motor and sensory functions in all patients at 15-minute intervals for 1 h, and pain scores were recorded. Results There was no difference in time to resolution of motor or sensory block in the two groups. The median changes in the motor score were 1.5 out of 10 for the control group and 2 for the washout group (p=0.95). The median changes in the sensory score were 3 out of 10 for the control group and 1 for the washout group (p=0.14). There were no differences in pain scores over the study period in either group (p=0.44). Conclusion We were unable to show any useful improvement in block resolution with normal saline washout of supraclavicular or infraclavicular brachial plexus blocks following AV fistula surgery. © Copyright 2020 by Turkish Anaesthesiology and Intensive Care Society.Objective Performance of safe central neuraxial blocks requires identification of accurate vertebral interspace. This study aimed to evaluate the accuracy of palpation method by confirmation with ultrasound in high-risk groups like obesity and pregnancy. Methods This cross-sectional comparative study was conducted after approval from the hospital ethics committee and written informed consent from participants. Participants were enrolled into four groups normal weight non-pregnant (N), full-term pregnant (P), obese (O) and obese full-term pregnant (PO). Tuffier's line at L4-L5 interspace was determined by palpation method and marked as P-line. Another examiner blinded to the marking done by palpation method confirmed it by ultrasound. The primary endpoint was to determine the accuracy of the palpation method, defined as true identification of Tuffier's line at the L4-L5 interspace by confirming it with ultrasound among four groups. Proportion and percentage were computed and analysed the true identification of Tuffier's line at L4-L5 by chi-square test at 0.008 adjusted level of significance for multiple comparisons. Results Tuffier's line identification by palpation method was confirmed by ultrasound scanning at L4-L5 interspace in 75.3% (226/300) of participants. Proportion difference of true identification of Tuffier's line at L4-L5 by palpation and ultrasound was statistically significant among the groups (p=0.0005). True identification was significantly lower in group PO [36.4%; p=0.0005 less then 0.008] and group O [34%; p=0.0005 less then 0.008] as compared to that in group N. Conclusion Palpation method was found to be the inaccurate surrogate for the L4-L5 vertebral interspace for obesity with or without pregnancy. © Copyright 2020 by Turkish Anaesthesiology and Intensive Care Society.Objective Preemptive transplantation cannot be performed for all patients because of the limited number of donors. This study aimed to evaluate the perioperative effects of dialysis before renal transplantation. Methods In this study, we retrospectively investigated 666 patients who underwent kidney transplantation at our centre. We divided patients into two groups patients with pre-transplant dialysis (67.3%, n=448) and patients with preemptive transplant (32.7%, n=218). We carried out preoperative, intraoperative and postoperative comparisons between groups. Results No difference was observed in terms of intraoperative blood transfusion, crystalloid and colloid requirement, inotropic-vasopressor agent administration and hemodynamic parameters between the patients with pre-transplant dialysis and preemptive transplant. It was observed that dialysis requirement, delayed graft function and acute rejection development were significantly higher during the postoperative period in patients who underwent dialysis before transplantation.