Effects of Single-Dose Preemptive Pregabalin and Intravenous Ibuprofen on Postoperative Opioid Consumption and Acute Pain after Laparoscopic Cholecystectomy

Purpose: Non-opioid medications as a part of multimodal analgesia has been increasingly suggested in the management of acute post-surgical pain. The present study was planned to compare the efficacy of the combination of pregabalin plus ?v ibuprofen. Methods: 58 patients were included in this prospective, randomized, double-blinded study. The pregabalin group (Group P, n = 29) received 150 mg pregabalin, the pregabalin plus ibuprofen group (Gropu PI, n = 29) received 150 mg pregabalin and 400mg ?v ibuprofen before surgery. Postoperative fentanyl consumption, additional analgesia requirements and PACU stay were recorded. Postoperative analgesia was performed with patient-controlled IV fentanyl. Results: VAS scores in the group PI were statistically lower at PACU, 1and 2 hours at rest, at PACU, 1, 2, 4, 12 and 24 hours on movement compared to the group P (P < 0.05). Opioid consumption was statistically significantly higher in the group P compared to the group PI (130.17 ± 60.27 vs 78.45 ± 60.40 μq, respectively, P < 0.001) and reduced in the 4th 24 hours by 55% in group PI. Rescue analgesia usage was statistically significantly higher in the group P than in the group PI (16/29 vs 7/29, respectively, P < 0.001). Four patient in the group PI did not need any opioid drug. Besides, PACU stay was shorter in the group PI than the group P (10.62 ± 2.38 vs 15.59 ± 2.11 min, respectively, P < 0.001). Conclusion: Preemptive pregabalin plus ?v ibuprofen in laparoscopic cholecystectomy reduced postoperative opioid consumption. This multimodal analgesic aproach generated lower pain scores in the postoperative period.     

Ocular complications of severe corneal abrasions after cosmetic blepharopigmentation

A 53-year-old woman with hemiparesis and poor dexterity, underwent cosmetic blepharopigmentation on the both upper eyelids in the dermatology clinic of a private hospital. She was not asked for any information on her medical history and no informed consent was obtained and the procedure was performed without any protective ocular shields. The patient experienced severe lacrimation, discomfort, and increased sensitivity to light during and after the procedure. She also noticed blurred vision after the procedure. Ophthalmologic examination revealed tender and oedematous eyelids and corneal abrasions in both of her eyes. Topical antibiotics and preservative-free lubricants were able to recover her from her signs and symptoms at 1-week follow-up. It is recommended that cosmetic blepharopigmentation should be applied cautiously with patient’s informed consent after obtaining a thorough medical history and with protective ocular shields to avoid potential complications.     

Effect of Tropicamide on Laser Flare Meter Measurements in Patients with Pseudoexfoliation

ABSTRACT

Purpose

To investigate the effect of 1% tropicamide on anterior chamber aqueous flare (ACAF) measurements acquired with laser flare meter in patients with pseudoexfoliation.     

Gender Dysphoria and Perceived Social Support: A Matched Case-Control Study

BackgroundIn people diagnosed with Gender Dysphoria (GD), low perceived social support from their families and society has been suggested to be associated with poor quality of life and mental well-being.AimTo compare the perceived social support in individuals with GD with that in individuals without GD matched for age and gender.MethodsThe study group (n = 50) consisted of individuals diagnosed with GD via psychiatric evaluation. A control group (n = 50) was created by matching volunteers without GD by age and gender. Sociodemographic data form, Structured Clinical Interview Form for DSM-IV TR Axis I Disorders (SCID-I), and Multidimensional Scale of Perceived Social Support (MSPSS) were used to gather data from participants.Outcomescomparing the perceived social support, the total and subscale MSPSS scores of groups were calculated.ResultsThe presence of at least 1 psychiatric disorder was significantly higher in the GD group than in the control group, either lifetime or during evaluation (P < .001 and P = .025, respectively). The total MSPSS and family support subscale scores were found to be significantly lower in the GD group than in the control group (P = .001 and P ≤ .001, respectively). When the groups formed on the basis of gender identity (32 trans men vs 32 cis men and 18 trans women vs 18 cis women) were compared, only the family support subscale score was found to be lower in trans men than cis men (P = .005). In addition, comparisons within the groups formed based on sex assigned-at-birth revealed lower total, friend, and family support in those assigned female-at-birth and lower total and family support in those assigned male-at-birth in the GD group. A multiple linear regression analysis revealed that the presence of GD was significantly associated with total and family support MSPSS subscale scores.Clinical ImplicationsThe findings show that perceived social support in people diagnosed with GD is lower, even when the presence of psychiatric disorders is included in the analysis.Strengths and LimitationsThe matched case-control design was the major study strength, whereas the sample size was the major limitation.ConclusionClinical care of people diagnosed with GD should include the evaluation of diverse sources of social support, efforts to strengthen family and friend support, maintenance of interpersonal relationships, and support of mental well-being.Kaptan S, Cesur E, Ba?ar K, et al. Gender Dysphoria and Perceived Social Support: A Matched Case-Control Study. J Sex Med 2021;18:812–820.     

A method for flap monitoring based on bioelectrical-resistance analysis

Axial pattern flaps are characterized by a single vascular pedicle that supplies the whole flap and carry the danger of flap loss. For this reason, monitoring and early identification of vascular perfusion is important for flap prognosis. The most commonly used method for flap monitoring is clinical assessment, but it has certain limitations. The bioelectrical properties of tissues can be affected by ischemic conditions, and a preliminary study showed that the bioelectrical resistance of blood was decreased under thrombotic conditions. In this controlled study, the resistance values of the axial flaps were calculated during thrombosis. A total of 28 rats were randomly divided into a control group (n = 14) and an experimental group (n = 14). Axial flaps were elevated based on the inferior epigastric pedicle. For the ischemic group, microvascular clamps were placed in the ischemic group to produce artificial thrombosis from day 1 of the experiment. Bioelectrical resistance was measured every 30 minutes for the first 6 hours and then daily after that. The resistance values from the ischemic group decreased progressively, and 150 minutes after the clamping, the difference became statistically significant (P < 0.05). The results showed that the assessment of flap resistance is a valuable tool and may allow early recognition of a compromise in the vascular system before clinical signs become obvious.     

Effect of bleaching on microhardness of esthetic restorative materials

This study evaluated the effect of a high-concentration carbamide peroxide–containing home bleaching system (Opalescence PF) and a hydrogen peroxide–containing over-the-counter bleaching system (Treswhite Supreme) on the microhardness of two nanocomposites (Filtek Supreme XT and Premise) and leucite-reinforced glass ceramic (Empress Esthetic), glass ceramic (Empress 2 layering), and feldspathic porcelain (Matchmaker MC). A total of 100 specimens, 20 of each kind of the restorative materials, 2 mm in thickness and 10 mm in diameter, were fabricated. Then the specimens were polished with SiC paper and 1 μm alumina polishing paste. After polishing, porcelain specimens were glazed in accordance with the manufacturer's instructions. Each type of restorative material was then randomly divided into two groups (n=10), and the specimens were treated with either Opalescence PF or Treswhite Supreme. The microhardness of the specimens before bleaching (baseline) and after bleaching was determined using a digital microhardness tester. Data were analyzed using the Mann-Whitney U-test and the Wilcoxon test. Opalescence PF significantly influenced the hardness of all the restorative materials. Statistically significant decreases with respect to before bleaching were found for Premise (p=0.005), Empress Esthetic (p=0.003), Empress 2 layering (p=0.005), and Matchmaker-MC (p=0.003), whereas a statistically significant increase was observed in Filtek Supreme XT (p=0.028). The difference in the microhardness values between before and after bleaching using Treswhite Supreme was statistically significant only for Premise (p=0.022). High-concentration carbamide peroxide–containing home bleaching may affect the microhardness of restorative materials.     

Comparison of autogenous mucosal grafts and collagen-based, solvent-preserved allografts for vestibuloplasty.

This study was designed to determine whether solvent-preserved dura mater and fascia lata grafts would be as effective as palatal mucosal grafts for vestibuloplasty. All graft systems succeeded in covering the alveolar ridge with firmly attached tissue, which is needed to ensure prosthetic stability. There was no remarkable reduction in area until the stents were removed. However, after 6 months of vestibuloplasty, there was a significant reduction in gained vestibular area in the fascia lata group, whereas no significant difference between dura mater and palatal grafts was observed. These findings suggest that dura mater could serve as a biologic oral dressing for mucosal defects as effectively as palatal grafts in vestibuloplasty.