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BACKGROUND AND OBJECTIVES: Epidural catheter bacteria filters are barriers in the patient-controlled analgesia/anaesthesia for preventing contamination at the epidural insertion site. The efficiency of these filters varies according to pore sizes and materials. METHOD: The bacterial adhesion capability of the two filters was measured in vitro experiment. Adhesion capacities for standard Staphylococcus aureus (ATCC 25923) and Pseudomonas aeruginosa (ATCC 27853) strains of the two different filters (Portex and Rusch) which have the same pore size were examined. Bacterial suspension of 0.5 Mc Farland was placed in the patient-controlled analgesia pump, was filtered at a speed of 5 mL/h. in continuous infusion for 48 h and accumulated in bottle. The two filters were compared with colony counts of bacteria in the filters and bottles. At the same time, the filters and adhered bacteria were monitored by scanning electron microscope. RESULTS: Electron microscopic examination of filters showed that the Portex filter had a granular and the Rusch filter fibrillary structure. Colony counting from the catheter and bottle showed that both of the filters have significant bacterial adhesion capability (p < 0.001). After the bacteria suspension infusion, colony countings showed that the Portex filter was more efficient (p < 0.001). There was not any difference between S. aureus and P. aeruginosa bacteria adhesion. In the SEM monitoring after the infusion, it was physically shown that the bacteria were adhered efficiently by both of the filters. CONCLUSION: The granular structured filter was found statistically and significantly more successful than the fibrial. Although the pore sizes of the filters were same - of which structural differences shown by SEM were the same - it would not be right to attribute the changes in the efficiencies to only structural differences. Using microbiological and physical proofs with regard to efficiency at the same time has been another important aspect of this experiment.

JUSTIFICATIVA E OBJETIVOS: Os filtros antibacterianos para cateter epidural são barreiras da analgesia/anestesia controlada pelo paciente para evitar a contaminação do local de inserção epidural. A eficácia desses filtros varia de acordo com o material e o tamanho dos poros. MÉTODO: A capacidade de aderência bacteriana dos dois filtros foi medida em experimento in vitro. Avaliamos a capacidade de aderência das cepas padrão de Staphylococcus aureus (ATCC 25923) e Pseudomonas aeruginosa (ATCC 27853) de dois filtros diferentes (Portex e Rusch), mas com poros do mesmo tamanho. Uma suspensão bacteriana grau 0,5 de McFarland foi colocada na bomba de analgesia controlada pelo paciente e filtrada a uma velocidade de 5 mL/h em infusão contínua por 48 horas e acumulada em frasco. Os dois filtros foram comparados com contagens de colônias de bactérias nos filtros e frascos. Ao mesmo tempo, os filtros e as bactérias aderidas foram monitorados com microscópio eletrônico de varredura. RESULTADOS: O exame dos filtros por microscópico eletrônico mostrou que a estrutura do filtro Portex era granulada e a do filtro Rusch fibrilar. A contagem de colônias do cateter e do frasco mostrou que ambos os filtros tinham uma capacidade de adesão bacteriana significativa (p < 0,001). Após a infusão da suspensão bacteriana, as contagens de colônias mostraram que o filtro Portex foi mais eficiente (p < 0,001). Não houve qualquer diferença entre as adesões de bactérias S. aureus e P. aeruginosa. Na monitoração por MEV após a infusão, ficou fisicamente evidente que as bactérias foram aderidas de modo eficaz por ambos os filtros. CONCLUSÃO: O filtro com estrutura granular foi estatística e significativamente mais bem- sucedido do que o filtro com estrutura fibrilar. Embora o tamanho dos poros dos filtros fosse igual - as diferenças estruturais mostradas pelo MEV eram semelhantes -, não seria justo atribuir as alterações de eficiência apenas às diferenças estruturais. O uso ao mesmo tempo de provas microbiológicas e físicas para avaliar a eficácia foi outro aspecto importante deste experimento.

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RESUMO

BACKGROUND AND OBJECTIVES: Epidural catheter bacteria filters are barriers in the patient-controlled analgesia/anaesthesia for preventing contamination at the epidural insertion site. The efficiency of these filters varies according to pore sizes and materials. METHOD: The bacterial adhesion capability of the two filters was measured in vitro experiment. Adhesion capacities for standard Staphylococcus aureus (ATCC 25923) and Pseudomonas aeruginosa (ATCC 27853) strains of the two different filters (Portex and Rusch) which have the same pore size were examined. Bacterial suspension of 0.5 Mc Farland was placed in the patient-controlled analgesia pump, was filtered at a speed of 5 mL/h. in continuous infusion for 48 h and accumulated in bottle. The two filters were compared with colony counts of bacteria in the filters and bottles. At the same time, the filters and adhered bacteria were monitored by scanning electron microscope. RESULTS: Electron microscopic examination of filters showed that the Portex filter had a granular and the Rusch filter fibrillary structure. Colony counting from the catheter and bottle showed that both of the filters have significant bacterial adhesion capability (p<0.001). After the bacteria suspension infusion, colony countings showed that the Portex filter was more efficient (p<0.001). There was not any difference between S. aureus and P. aeruginosa bacteria adhesion. In the SEM monitoring after the infusion, it was physically shown that the bacteria were adhered efficiently by both of the filters. CONCLUSION: The granular structured filter was found statistically and significantly more successful than the fibrial. Although the pore sizes of the filters were same - of which structural differences shown by SEM were the same - it would not be right to attribute the changes in the efficiencies to only structural differences. Using microbiological and physical proofs with regard to efficiency at the same time has been another important aspect of this experiment.

Assuntos

RESUMO

BACKGROUND AND OBJECTIVES: Epidural catheter bacteria filters are barriers in the patient-controlled analgesia/anaesthesia for preventing contamination at the epidural insertion site. The efficiency of these filters varies according to pore sizes and materials. METHOD: The bacterial adhesion capability of the two filters was measured in vitro experiment. Adhesion capacities for standard Staphylococcus aureus (ATCC 25923) and Pseudomonas aeruginosa (ATCC 27853) strains of the two different filters (Portex and Rusch) which have the same pore size were examined. Bacterial suspension of 0.5 Mc Farland was placed in the patient-controlled analgesia pump, was filtered at a speed of 5mL/h. in continuous infusion for 48h and accumulated in bottle. The two filters were compared with colony counts of bacteria in the filters and bottles. At the same time, the filters and adhered bacteria were monitored by scanning electron microscope. RESULTS: Electron microscopic examination of filters showed that the Portex filter had a granular and the Rusch filter fibrillary structure. Colony counting from the catheter and bottle showed that both of the filters have significant bacterial adhesion capability (p<0.001). After the bacteria suspension infusion, colony countings showed that the Portex filter was more efficient (p<0.001). There was not any difference between S. aureus and P. aeruginosa bacteria adhesion. In the SEM monitoring after the infusion, it was physically shown that the bacteria were adhered efficiently by both of the filters. CONCLUSION: The granular structured filter was found statistically and significantly more successful than the fibrial. Although the pore sizes of the filters were same - of which structural differences shown by SEM were the same - it would not be right to attribute the changes in the efficiencies to only structural differences. Using microbiological and physical proofs with regard to efficiency at the same time has been another important aspect of this experiment.

RESUMO

OBJECTIVE: A prospective, randomized and double-blind study was planned to identify the optimum dose of esmolol infusion to suppress the increase in bispectral index values and the movement and hemodynamic responses to tracheal intubation. MATERIALS AND METHODS: 120 patients were randomly allocated to one of three groups in a double-blind fashion. 2.5mgkg(-1) propofol was administered for anesthesia induction. After loss of consciousness, and before administration of 0.6mgkg(-1) rocuronium, a tourniquet was applied to one arm and inflated to 50mmHg greater than systolic pressure. The patients were divided into 3 groups; 1mgkg(-1)h(-1) esmolol was given as the loading dose and in Group Es50 50µgkg(-1)min(-1), in Group Es150 150µgkg(-1)min(-1), and in Group Es250 250µgkg(-1)min(-1) esmolol infusion was started. Five minutes after the esmolol has been begun, the trachea was intubated; gross movement within the first minute after orotracheal intubation was recorded. RESULTS: Incidence of movement response and the ΔBIS max values were comparable in Group Es250 and Group Es150, but these values were significantly higher in Group Es50 than in the other two groups. In all three groups in the 1st minute after tracheal intubation heart rate and mean arterial pressure were significantly higher compared to values from before intubation (p<0.05). In the study period there was no significant difference between the groups in terms of heart rate and mean arterial pressure. CONCLUSION: In clinical practise we believe that after 1mgkg(-1) loading dose, 150µgkg(-1)min(-1) iv esmolol dose is sufficient to suppress responses to tracheal intubation without increasing side effects.

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INTRODUCTION: In this study we aimed to develop a simple and practical technique for chronic sacral epidural catheterization of rabbits. METHODS: We included ten rabbits weighing 2-2.5 kg in the study. After anesthesia and analgesia, we placed an epidural catheter by a 2 cm longitudinal skin incision in the tail above the sacral hiatus region. We confirmed localization by giving 1% lidocaine (leveling sensory loss and motor function loss of the lower extremity). The catheter was carried forward through a subcutaneous tunnel and fixed at the neck. RESULTS: Chronic caudal epidural catheter placement was succesful in all rabbits. The catheters stayed in place effectively for ten days. We encountered no catheter complications during this period. The localization of the catheter was reconfirmed by 1% lidocaine on the last day. After animals killing, we performed a laminectomy and verified localization of the catheter in the epidural space. CONCLUSIONS: Various methods for catheterization of the epidural space in animal models exist in the literature. Epidural catheterization of rabbits can be accomplished by atlanto-occipital, lumbar or caudal routes by amputation of the tail. Intrathecal and epidural catheterization techniques defined in the literature necessitate surgical skill and knowledge of surgical procedures like laminectomy and tail amputation. Our technique does not require substantial surgical skill, anatomical integrity is preserved and malposition of the catheter is not encountered. In conclusion, we suggest that our simple and easily applicable new epidural catheterization technique can be used as a model in experimental animal studies.

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INTRODUCTION: Line type blood-liquid warmers are used widely due to their low expense, practical use and nondependence on sets. We aimed to investigate the relationship of bubbles in line type warmers with two different warming properties. MATERIALS AND METHODS: Two groups were designed with S-line and Astoflo® brand blood-liquid warmers. By using 10 medisets for each group (n = 20), we infused 1,000 mL 0.9% NaCl solutions at 350 mL.hour-1 speed for one hour in the operating room. Temperatures at the proximal, midway and distal parts of lines, temperature of experiment environment, temperature of liquid used and temperature of liquid reaching the cannula after warming were measured. Time to visually observable bubble formation was recorded. We compared findings statistically using the Mann-Whitney U test. RESULTS: There were no differences between the groups with respect to temperatures at the proximal, midway and distal parts of lines, temperature of experiment environment, temperature of liquid used and temperature of liquid reaching the cannula (p > 0.05). Bubbles were observed with both warmers and time to bubble formation was similar in the two study groups (p = 0.143). CONCLUSIONS: In the experimental setting, we have designed conditions similar to our clinical environment. Both types of warmers provided similar warming levels and formed visible bubbles. Considering that low amounts of emboli can be fatal in infants and children, bubble formation should be taken seriously into account for emboli and further studies should be carried out to determine the amount, the reasons and the contents of bubble formation.

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