Objective: In this study, we compared the efficiency and side effects of the postoperative analgesia methods in pediatric population undergoing outpatient lower abdominal surgery.
Study design: After induction of anesthesia, patients were randomly divided into 3 groups. At the end of surgery, the first group of patients (n-10) were administered 1 mg/kg 0,25 % bupivacain in incision site, the second group (n-10) received 20- 25 mg/kg rectal paracetamol. The third group (n-10) had caudal block with 2mglkg bupivacain diluted with saline to obtain Iml/kg solution. Peroperatively, patients’ heart rale and 02 saturation levels were monitorised and during 6 hours postoperatively, respiratory> rate, heart rate, sedation and modified TPPPS pain scale were noted for all the patients every hour In the next 6 hours, the same parameters were followed up by phone, in discharged patients. According to modified TPPPS pain score, rectal 20-30 mg/kg paracetamol were administered to the patients who had a score level more than 3. And this treatment was continued at home.Chi-square and Fisher’s exact test were used for statistical analyses. p<0,05 was considered statistically significant.
Results: The recovery time was significantly long in the 3rd group and the first hour pain score in the 2nd group was statistically high. (p<0,05) In 3 patients of the 3rd group, side effects such as nausea and vomiting, urine retention were observed.
Conclusion: We believe that the infiltration of local anesthetic in incision site or the administration of rectal paracetamol may be a good alternative to caudal block in pediatric patients undergoing outpatient lower abdominal surgery.

Objective: The aim of this study was to compare the peroperative hemodynamic parameters and postoperative recovery effects of remifentanil and alfentanil on patients undergoing tonsillectomy. Study design: 30 pediatric patients were randomly divided into two groups. All of the patients received the same anesthetics agents during induction. Group R had 1 meg/kg bolus then 0,5 mcg/kg/min infusion dose of remifentanil. Group A had 10 mcg/kg bolus then 2,5 mcg/kg/min infusion dose of alfentanil. Anesthesia, surgery and extubation times of each pa¬tient were registered. At the begining, during intubation, before and after installation of mouth-opening device, before and after tonsillectomy incision and during extubation SBP, DBP, HR and Sp02 values were noted. After extubation hemodynamic parameters, PACU discharge scores and CHEOPS pain scores were registered. Results: In Group A, HR was found significantly higher du¬ring intubation. In group R, before and after installation of mouth-opening device, before and after tonsillectomy incision the SBP values were found significantly lower. Extubation time was significantly longer in Group A. In Group A, postoperative Sp02 values were significantly low. The PACU scores of Group R at the first minute was high (p <0.05). Conclusion: Our study shows that in pediatric tonsillectomies in comparison with alfentanil, remifentanil gives better hemodynamic stability, allows earlier extubation and causes less hypoxia during postoperative period.

We aimed of evaluating current anesthetic practice and regional anesthesia enthusiasm. Despite a trend toward the use of regional anaesthesia,we evaluated our regional anesthesia frequences and preferences in anesthesia practice of urologic surgery. Our range of regional anaesthesia was 37. 5 % in between 2000-2004 and the most preferable type of regional anaesthesia was spinal anaesthesia.

Objective: The aim of the present study was to evaluate the mumps infection course in patients who admitted to Okmeydanı Training and Research Hospital Pediatric Emergency Department with complaints of painful enlargement of parotids gland and diagnosed as mumps infection.
Material And Methods: One hundred and five patients who admitted to pediatric emergency department between 2nd of july 2004 and 30th of july 2004 with complaints of painful enlargement of parotid glands and diagnosed as mumps infection were included into the study. After medical history was taken and physical examination was done venous blood was taken twice apart 1 week for measurement of serum amylase and lipase levels.
Conclusion: Mumps infection is still common in our country. MMR vaccine should take place in routine vaccination program in our country to prevent mumps infection and its complications.

Marjolin’s ulcer can be termed as a malignant tumor arising in chronic scar tissue. Although mostly seen in burn scars, it can occur in the presence of other chronic wounds. We present a total of 16 Marjolin’s ulcers of 15 patients treated in our clinic between 1998 and 2005. Patients had a mean age of 49.8 years and showed 67% male predominance. Lesions were located at the trunk, upper limbs and lower limbs. 12 cases presented with a tumor diameter less than 10 cm. Mean scar age was 36,12. Mean ulcer diameter was 8,56 cm. Initial lymphadenopathy was detected at 4 of our cases. His- topathologically, preoperative biopsies revealed dysplasia in 3 cases, carcinoma in situ in 2 cases, and epidermoid carcinoma in 11 cases. Resection followed by either skin grafting or local flaps were performed for all the patients. Surgical margins were applied as 2 cm for all cases except the cases with dysplasia, where surgical margins were applied as 1 cm. Six of the cases were gone under regional lymph node dissection simultaneously with the resection. Two of the cases took further radiotheraphy. Except the case with tumor at two distinct locations, no reccurence was seen at the follow-ups. Two cases were lost with metastasis.

Mucocele of appendix, a cystic mass resulting from dilated appendiceal lumen caused by abnormal accumulation of mucus, is a rare entity. The incidence of mucocele in appendectomy specimens is about %0.25. The preoperative diagnosis of mucocele of the appendix is important because of the possibility of rupture at surgery with development of pseudomyxoma peritonei and to predict malignant transformation. In this case report; we aimed to reveal the findings in ultrasonography and computed tomography in diagnosing appendiceal mucocele and discriminating it from mimicking conditions.

Apert’s syndrome is a congenital disorder characterized by cranyositosis, maxillary hypoplasia and syndactyly accompanied by cardiac, gastrointestinal and genitourinary defects. General anesthesia frequently applied to pediatric patients with Apert’s syndrome for orthopedic surgeries. In this paper, we reported our general anesthesia application to a 3-months female case diagnosed with Apert’s syndrome. We used sevoflurane 1-8 % and fentanyl (1 meg.kg-1) for anesthesia induction and maintained anesthesia with nitrous oxide 40 %, oxygen, and sevoflurane 1-3 % after introducing laryngeal mask airway (LMA). There were not seen any problems during anesthesia.

Primary duodenum lymphoma is a rare clinical entity. In differential diagnosis of patients with obstructive jaundice, it is often not thought. In this report, a patient who came with complaints of jaundice, itching and weight loss and was diagnosed as non-hodgkin lymphoma through a biopsy from second part of duodenum is presented.