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    Anesthetic management of two siblings with congenital insensitivity to pain with anhidrosis syndrome
    (Kare Publ, 2019) Destegul, Dilek; Kocaoz, Fazilet; Sari, Ahmet Sinan
    Congenital insensitivity to pain with anhidrosis (CIPA) is a rare syndrome characterized by a lack of sensitivity to pain due to congenital sensory and autonomic neuropathies, anhidrosis, an inability to regulate body temperature, growth retardation, mental retardation at different levels of severity, and inadvertent self-harm. It is an autosomal recessive disorder that is result of a mutation in the neurotrophic receptor tyrosine kinase 1 gene, which encodes neurotrophic tyrosine kinase. CIPA patients are frequently admitted to hospitals with unrecognized traumatic fractures and unhealed wounds due to the lack of a pain response. Presently described is the method of anesthetic management used for 2 siblings, aged 17 and 14 years, with a generalized lack of pain, anhidrosis, mental retardation, and septic arthritis. Sedation with midazolam alone provided satisfactory surgical comfort without causing hemodynamic instability in these 2 patients with CIPA syndrome.
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    Effect of Sugammadex on Coagulation Parameters in Cesarean Section Patients a Prospective Controlled Observational Study
    (Aves, 2021) Destegul, Emre; Destegul, Dilek; Kocaoz, Fazilet
    Objective: To evaluate, for the first time in the literature, the effect of sugammadex in elective C/S patients in terms of hemostatic parameters and postoperative bleeding. Methods: Seventy-six patients enrolled for this observational prospective controlled study. Patients were divided into two groups according to anesthetic reversal agent: sugammadex (group I) vs neostigmin (group II). Intraoperative and postoperative amount of bleeding were recorded. At the end of the surgery, after administration of reversal agent, and at postoperative 30th minute, 1st, and 2nd hours, activated partial thromboplastin time (aPTT), prothrombin time (PT), and international normalized ratio (INR) values were recorded. Postoperative Hct, Hgb, and Plt values at 6th and 24th hours of reversal agent administration were also recorded. Results: Alterations in aPTT, PT, and INR values were similar between the groups (P = .986, .549, .05, respectively). Conclusion: Sugammadex at 2 mg kg(-1) in cesarean section patients has a similar effect on coagulation parameters compared to neostigmin. Further studies are needed particularly in patients under thromboprophylaxis.