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    Comparison of the effects of magnesium and ketamine on postoperative pain and morphine consumption. A double-blind randomized controlled clinical study
    (Acta Cirurgica Brasileira, 2016) Arikan, Muge; Aslan, Bilge; Arikan, Osman; Horasanli, Eyup; But, Abdulkadir
    PURPOSE: To compare the effects of magnesium sulfate and ketamine on postoperative pain and total morphine consumption in a placebo-controlled design. METHODS: One hundred and twenty women scheduled for total abdominal hysterectomy were included in this prospective, randomized, double-blind study. Postoperatively, when the Numeric Pain Rating Scale (NPRS) was four or more, IV-PCA morphine was applied to all patients. The patients were randomized into three groups: Group K ketamine, Group M magnesium, and Group C saline received as infusion. Total morphine consumption for 48h, pain scores, adverse effects, and patients' satisfaction were evaluated. RESULTS: Total morphine consumption was significantly lower in Group K (32.6 +/- 9.2 mg) than in Group M (58.9 +/- 6.5 mg) and in Group C (65.7 +/- 8.2 mg). The satisfaction level of patients in Group K was higher than the other two groups (p<0.05). Pruritus and nausea were observed more frequently in Group C. CONCLUSION: The addition of ketamine to IV-PCA morphine reduces the total consumption of morphine without psychotic effects; however, magnesium did not influence morphine consumption.
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    Intrathoracic migration of a Kirschner wire
    (Oxford Univ Press, 2014) Ozarslan, Fatma; Arikan, Osman; Acat, Murat; Arikan, Muge; Temel, Volkan
    Kirschner (K) wires can easily migrate, resulting in serious complications. We report a 49-year-old woman who had a rare and late complication related to the migration of K wire. It had been used for left hip replacement 8 years ago. The patient admitted to our hospital with breathing-dependent chest pain and increasing dyspnea for similar to 2 h. Chest X-ray and chest computed tomographic scans revealed the presence of a metallic image of similar to 5-6 cm in the right hemithorax. There was a large hemothorax but no pneumothorax. A right thoracotomy was performed and the wire was removed without complications. Surprisingly, no injury was noted to any intervening abdominal structure intra-operatively. Patients, who are treated with K wire, should be informed of the risk of wire migration and should undergo regular postoperative follow-ups including radiography.