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    Effect of low dose dexmedetomidine premedication on propofol consumption in geriatric end stage renal disease patients
    (2015) Ergeneoglu, Pinar; Akin, Sule; Bali, Cagla; Eker, Hatice Evren; Cok, Oya Yalcin; Aribogan, Anis; 26323728
    Background and objective: Sedation in dialysis dependent end-stage renal disease patients requires caution as a result of performing high doses of sedatives and its complications. Multidrug sedation regimens might be superior and advantage on lesser drug consumption and by the way adverse events which occur easily in end-stage renal disease patients. We evaluated the effects of dexmedetomidine premedication on propofol consumption, sedation levels with Observer's Assessment of Alertness and Sedation scores and the bispectral index and the hemodynamic changes, potential side effects in geriatric patients with end-stage renal disease who underwent hip fracture surgery under spinal anesthesia. Method: In this randomized, controlled, double-blind study 60 elderly patients (age >= 65 years) with end-stage renal disease and hip fracture scheduled for anterograde femoral intramedullary nailing were assigned to groups that received either intravenous saline infusion (Group C) or dexmedetomidine 0.5 mu g/kg/10 min infusion for premedication (Group D). All the patients received propofol infusion after the induction of the spinal anesthesia. Results: Total propofol consumption, propofol dose required for targeted sedation levels according to Observer's Assessment of Alertness and Sedation scores and bispectral index levels, recovery times were significantly lower in Group D (p< 0.001). The time to reach to Observer's Assessment of Alertness and Sedation score 4 and to achieve bispectral index <= 80 was significantly lower in Group C compared with Group D (p< 0.001). Adverse events were similar in both groups. Conclusion: Dexmedetomidine premedication lowers intraoperative propofol consumption to maintain targeted level of sedation. Therefore low dose dexmedetomidine premedication in addition to propofol infusion might be an alternative in geriatric patients with end-stage renal disease for sedation. (c) 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.
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    Congenital insensitivity to pain: How should anesthesia be managed?
    (2017) Ozmete, Ozlem; Sener, Mesut; Bali, Cagla; Caliskan, Esra; Aribogan, Anis; 0000-0003-2615-1918; 0000-0001-6497-0610; 0000-0002-4419-5693; 0000-0001-5845-699X; 29168371; AAI-7779-2021; AAI-8790-2021; S-8336-2019; AAI-7866-2021
    Congenital insensitivity to pain syndrome is a rare, sensorial and autonomic neuropathy characterized by unexplained fever, insensitivity to pain and anhidrosis. Patients may require anesthesia even for minor surgical procedures due to mental retardation and trauma arising from self-mutilating behavior. A child diagnosed with congenital insensitivity to pain syndrome was scheduled for gastric endoscopy under sedation due to suspected ingestion of a household cleaning disinfectant. Deep sedation was achieved, and spontaneous respiration was maintained. We did not encounter any complications. There is limited data regarding the safe anesthesia management in these patients because of the rarity of the disease. Therefore, we think that more clinical experience, case reports and studies are needed to establish the appropriate anesthesia management.