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Öğe Abuse potential assessment of propofol by its subjective effects after sedation(Professional Medical Publications, 2014) Tezcan, Aysu Hayriye; Örnek, Dilşen Hatice; Özlü, Onur; Baydar, Mustafa; Yavuz, Nurcan; Özaslan, Nihal Gökbulut; Keske, AylinObjective: In this study, we examined the euphoric effect of propofol and its high satisfaction ratio regarding its liability to be abused, particularly in painless procedures, such as colonoscopy. Methods: Fifty subjects aged between 18 and 65 years who fulfilled the criteria for ASA 1-2 and were prepared for colonoscopy were enrolled into this study. For intravenous sedation induction, 2 mg/kg propofol was used, and additional injections were administered according to BIS values. After colonoscopy, the subjects were taken to a recovery room and observed for 30 minutes. Patients were interviewed with the modified Brice questionnare regarding the incidence and the content of dreams. A 5-point Likert scale was used to classify their dreams, and the content of the dreams was also recorded. To assess the subjective effects of propofol, the patients were asked to use the Hall and Van der Castle emotion scale; their biological states were also assessed. The patients' feelings regarding propofol were each rated as absent or present. We used the Morphine-Benzedrine Group scale to measure the euphoric effects of propofol. At the end of the study, subjects scored their satisfaction on a five-point scale. Results: There were no statistically significant differences in sex age, weight, propofol dose, or satisfaction ratio (p > 0.05) in the groups, although male patients received a higher dose of propofol and had higher satisfaction ratio. Patients reported no residual after-effects. The incidence of dreaming was 42%. There was no statistically significant difference in dreaming between the sexes, but male patients had a higher dreaming ratio. Dreamers received higher propofol doses and had a higher satisfaction ratio (p > 0.05). All dreamers reported happy dreams regarding daily life, and their mean MBG score was 10.5. There was no correlation between MBG scores and propofol doses (r = -0.044, p = 0.761). Conclusions: We conclude that propofol functions as a reward; that patients enjoy its acute effects; and that no residual after-effects should arise. We suggest that propofol may carry potential for abuse, and further abuse liability testing is indicated.Öğe Açık septorinoplasti olgularında preemptif analjezi uygulamalarının ameliyat sonrası analjezideki etkinliği nedir?(2016) Keskioğlu, İlknur; İnal, Meltem Aktay; Özlü, OnurAmaç: Elektif septorinoplasti cerrahisi uygulanan hastalarda, cerrahi insizyon öncesi iv deksketoprofen trometamol ve asetaminofen uygulamasının, ameliyat sonrası ağrı skorları, analjezik ihtiyaçları, hemodinamik parametreler, 24 saat sonunda hasta memnuniyeti ve hasta kontrollü analjezi yöntemi ile toplam tramadol tüketimi üzerindeki etkilerini karşılaştırmayı amaçladık.Gereç ve Yöntem: Genel anestezi altında elektif septorinoplasti planlanan, 60 olgu, üç gruba ayrıldı. Grup D'de (n20) 50 mg iv deksketoprofen trometamol, Grup A'da 1 gr iv asetaminofen cilt insizyonundan önce uygulandı. Grup K'da (n20) cerrahi insizyon öncesi analjezik uygulanmadı. Ameliyat sonrası analjezi, iv hasta kontrollü analjezi yöntemi ile tramadol uygulayarak sağlandı. Ameliyat sonrası 15, 30. dakika, 1., 2., 6., 12., 24. saatlerde VAS skorları, sistolik, diastolik, ortalama arter basınçları, kalp atım hızı ile 24. saatin sonundaki toplam tramadol tüketim miktarları ve hasta memnuniyeti değerlendirildi.Bulgular: Gruplar arasında demografik özellikler, anestezi ve cerrahi süreleri açısından istatistiksel anlamlı fark saptanmadı (p0.05). VAS değerleri en yüksek Grup K'da, en düşük ise Grup D'de saptandı (p0.001). Toplam tramadol tüketim miktarları karşılaştırıldığında Grup K ve Grup A arasında istatistiksel anlamlı fark olmamakla birlikte Grup D'den daha yüksek dozda tramadol tüketildiği gözlenmiştir (p0.649 ve p0.05) İlk analjezik istem zamanı ve yan etkiler gruplar arasında benzer bulundu.Sonuç: Genel anestezi altında yapılan septorinoplasti ameliyatlarının erken ameliyat sonrası döneminde analjezi sağlamada, preemptif intavenöz deksketoprofen trometamol veya asetaminofen uygulamasının ameliyat sonrası ağrı tedavisinde etkin analjezi sağladığını gözlemledik. Ayrıca preemptif deksketoprofen trometamol uygulamasının erken ameliyat sonrası analjezi sağlamada asetaminofene göre daha etkili olduğunu tespit ettik.Öğe Comparing the effects of preemptive ketamine and lornoxicam on postoperative tramadol consumption in patients undergoing laparoscopic cholecystectomy(Anestezi Dergisi, 2016) Şengül, Eda Pepe; İnal, Meltem Aktay; Ceylan, Asiye; Ütebey, Gülten; Özlü, OnurObjective: To compare the postoperative analgesic effects of a preemptive intravenous ketamine and lornoxicam in patients undergoing laparoscopic cholecystectomy. Method: A total of 60 ASA I-II patients were included in this study and divided into three groups. Patients in Group KE were given 0.5 mg kg-1 ketamine, Group L were given 8 mg lornoxicam and in Group C were given 2 mL saline before surgical incision. All cases underwent general anesthesia and received postoperative patient-controlled analgesia with tramadol. VAS (Visual Analogue Scale) scores, at 0.,15.,30.th minutes and I .,2.,6.,12.,24.th hours, tramadol consumption, time and amount of additional analgesia were recorded Results: VAS scores, at 0., 15., 30. minutes and first hour were lower in group KE and L than group C (p<0.001) and there wasn't any difference between group KE and L (p>0.05). There was no significant difference between three groups regarding VAS scores at 2, 6,12, 24.'h hours (p>0.05). Time to first analgesia was later in group L than group C and KE (p<0.05). There was no difference between groups regarding to additional analgesia requirement. Tramadol consumption was lower in group L than group C, and there was no difference between group KE and group C.Conclusion: Lornoxicam and ketamine reduced the early postoperative pain and lornoxicam reduced total tramadol consumption more effectively than ketamine.Öğe A comparison of transversus abdominis plane block guided with ultrasonography and local anesthetic infiltration in laparoscopic cholecystectomy operations(Kare Publ, 2018) Dost, Burhan; Sezen, Gülbin Yalçın; İskender, Abdülkadir; Özlü, OnurObjectives: The aim of this study was to compare a transversus abdominis plane (TAP) block guided with ultrasound (USG) and local anesthetic infiltration (LAI) in terms of the intraoperative and postoperative analgesia efficiency, intraoperative opioid need, and side effects in cases of laparoscopic cholecystectomy. Methods: A total of 75 patients classified as American Society of Anesthesiologists class I or II were included in this randomized, controlled, prospective study and divided into 3 groups. 20 mL of levobupivacaine 0.5% was applied around the trocar entrance site before the operation to group L (n=25), and 30 mL 0.25% levobupivacaine was applied with a USG-guided TAP block to group T (n=25). No TAP block or LAI was applied to the control group (n=25), group K. In the first 24 hours after surgery, an infusion of tramadol was administered with a controlled analgesia device. The intraoperative fentanyl use was recorded, and a visual analogue scale was administered to assess pain while resting (VAS rest) and upon coughing (VAS cough) at 1, 2, 4, 8, 12, 16, and 24 hours postoperative. An evaluation of shoulder pain and the consumption of analgesia in 24 hours were also recorded. Results: The VAS rest and VAS cough values, the dose of fentanyl used intraoperatively, and the total analgesia dose administered in 24 hours were compared between groups and there was no statistically significant difference detected (p>0.05). In group T, the vomiting rate 1 and 2 hours postoperative (20% and 12%, respectively) was significantly lower than in group K (64% and 44%, respectively). Conclusion: The efficiency of the analgesia provided after a laparoscopic cholecystectomy with a bilateral TAP block guided with USG and LAI was determined to be similar.Öğe Does premedication with dexmedetomidine provide perioperative hemodynamic stability in hypertensive patients?(Biomed Central Ltd, 2014) Sezen, Gülbin; Demiraran, Yavuz; Şeker, İlknur Suidiye; Karagöz, İbrahim; İskender, Abdülkadir; Ankaralı, Handan; Özlü, OnurBackground: Perioperative hemodynamic fluctuations are seen more often in hypertensive patients than in normotensive patients. The purpose of our study was to investigate the perioperative hemodynamic effects of dexmedetomidine and midazolam used for premedication in hypertensive patients relative to each other and in comparison to normotensive patients. Methods: One-hundred-forty female, normotensive or hypertensive patients undergoing myomectomies or hysterectomies. They were randomly enrolled into the subgroups: Group ND (normotensive-dexmedetomidine); Group HD (hypertensive-dexmedetomine); Group NM (normotensive-midazolam); Group HM (hypertensive-midazolam). Dexmedetomidine was administered at a concentration of 0.5 mu g.kg(-1), and midazolam was administered at a concentration of 0.025 mu g.kg(-1) via intravenous (IV) infusion before the induction of anaesthesia. Haemodynamic parameters were recorded at several times (T-beginning, T-preop5 min, T-preop 10 min, T-induction, T-intubation, T-intubation 5 min, T-initial surgery, T-surgery 15 min, T-surgery 30 min, T-extubation, T-extubation 5 min). Propofol amount for induction, time between induction and initial surgery, demand of antihypertensive therapy, rescue atropine were recorded. Quantitative clinical and demographic characteristics were compared using One Way ANOVA. The values were compared using One-way Analysis of Variance. Additionally periodic variations were examined by One way Repeated Measures Analysis of Variance for groups separately. Results: SBP was significantly different between normotensive and hypertensive groups at the following time points: T-preop 5 min, T-preop 10 min, T-induction, T-intubation, T-intubation 5 min and T-initial surgery. MBP was significantly different in the hypertensive groups at T-induction, T-intubation, T-intubation 5 min, T-initial surgery, T-surgery 15 min, T-surgery 30 min, T-extubation and T-extubation 5 min. The perioperative requirements for antihypertensive drugs were significantly higher in Group HM. Conclusion: In the hypertensive patients, dexmedetomidine premedication provides better hemodynamic stability compared with midazolam, and because it decreases the antihypertensive requirements, its use might be beneficial.Öğe Effect of chronic obstructive pulmonary disease on washout time of sevoflurane anesthesia: a placebo controlled randomized trial(E-Century Publishing Corp, 2016) Şeker, İlknur Suidiye; Demiraran, Yavuz; Haftacı, Engin; Cangür, Şengül; Sezen, Gülbin; Özlü, Onur; Karagöz, İbrahimBackground: Respiratory functions and gas exchange deteriorates in patients with COPD. In our study, we aimed to investigate if there is any relationship between the washout time of sevoflurane and chronic obstructive pulmonary disease (COPD). Method: Sixty patients, American Society of Anesthesiology (ASA) 1-3 status; aged between 18-60 years old who underwent general anesthesia for an operation were enrolled in our study. Patients were divided into two groups: Group N (non-COPD n = 33), group COPD (patients with COPD, n = 33). Two patients were excluded from the study, a total of 31 patients in Group COPD. Pre-operative respiratory function tests were performed and standard monitoring was provided in the operation room. Both groups received propofol 2 mg/kg, fentanyl 1.5-2 mcg/kg and rocuronium 0.6 mg/kg intravenously, and an oxygen-air mixture of 50%/50% with a tidal volume of 6 ml/kg (ideal body weight) and sevoflurane of 1 MAC. Remifentanil was administered at 0.05-0.1 mcg/ kg/min intravenously in the maintenance of anesthesia. All patients were monitored by an anesthesia machine until extubation. A sevoflurane vaporizer was closed at the end of the operation and the measurement time was started. FiO2, Fi(ins), Fi(exp) of sevorain, End-tidal CO2 were recorded during the operation and Fins (Sevo)/Fexp (Sevo) ratio, MAC1, MAC2, MAC3, MAC4, extubation times were recorded. Fi(ins)1: percentage of sevorain filiation in inspirium before closing 1 MAC vaporizer. Fi(exp)1: percentage of sevorain filiation in expirium before closing 1 MAC vaporizer. Fi(ins)2: percentage of sevorain filiation in inspirium after closing 0.1 MAC vaporizer. Fi(exp)2: percentage of sevorain filiation in expirium after closing 0.1 MAC vaporizer. Results: There was no significant relationship between the respiratory function tests of individuals with or without COPD and MAC1, MAC2, MAC3, MAC4 and extubation time (P > 0.05). The cut-off criterion for MAC4 was determined to be 210 seconds. Conclusion: Although there was no difference between the washout and extubation times of both groups, increased BMI and decreased intraoperative hemoglobin values should be carefully considered during anesthetic management in the COPD group.Öğe Effect of Smoking on Reversing Neuromuscular Block(Aves, 2016) Öztürk, Ömür; Sezen, Gülbin Yalçın; Ankaralı, Handan; Özlü, Onur; Demiraran, Yavuz; Ateş, Hakan; Dost, BurhanObjective: Rocuronium is a non-depolarising, intermediate-acting, monoquaternary amino steroid and was brought into clinical use as a potentially ideal muscle relaxant. Post-operative residual curarisation (PORC) results from the prolonged effects of non-depolarising neuromuscular blocking agents. This is a common problem and seriously affects patient safety. No recent study has investigated the effects of sugammadex on smokers, which is often used to restore neuromuscular block and avoid PORC. This study compares the severity of the effects of sugammadex used for antagonising rocuronium bromide and antagonism durations in smokers and non-smokers. Methods: This randomised, prospective study included 40 patients scheduled for elective surgery and belonging to classes I and II based the American Society of Anesthesiologists classification, who were either smokers for at least 10 years or non-smokers. Patients underwent routine and neuromuscular monitoring. At induction, 2 mg kg(-1) propofol and 1 mcg kg(-1) intravenous fentanyl were applied. After the loss of eyelash reflex, 0.6 mg kg(-1) intravenous rocuronium was administered. Patients were intubated at train of four (TOF) 2. Anaesthesia was continued with 50% O-2 + 50% air and 2% sevoflurane. Rocuronium, 0.15 mg kg(-1), was administered at TOF 2 during the operation. At the end of the operation, 2 mg kg(-1) sugammadex was administered. The times until TOF 0.7, 0.8 and 0.9 were recorded. Results: Intubation time was 132.8 +/- 46.4 s for smokers and 127.6 +/- 32.7 s for non-smokers. After sugammadex administration, the time to TOF 0.7 was 153.3 +/- 54.7 s in smokers and 125 +/- 67.2 s in non-smokers. The times were 178.4 +/- 58.8 and 146.6 +/- 72.6 s for TOF 0.8 and 200.8 +/- 55.8 s and 170.4 +/- 77.8 s for TOF 0.9 in smokers and non-smokers, respectively. Conclusion: Although not statistically significant, the time to reach each TOF was longer for smokers. Larger populations and different perspectives are needed to find if sugammadex use is affected by smoking, which has negative effects on the body.Öğe The effect of vitamin D status on different neuromuscular blocker agents reverse time(2020) Yorulmaz, İlknur; Demiraran, Yavuz; Özlü, Onur; Dost, BurhanBackground/aim: This study is aimed to investigate the effects of vitamin D levels on sugammadex and neostigmine reversal times.Material and methods: Eighty patients between the ages of 18 and 65 years, with ASA I-III status who were undergoing surgery undergeneral anesthesia were included in the study. A double blind fashion was used to randomly divide all the patients into two groups. Atthe end of the operation, sugammadex 2 mg/kg was administered to one group (Group sugammadex) and atropine and neostigminewas administered to the other group (Group neostigmine) intravenously. In the data analysis stage, the group was divided into twosubgroups according to sugammadex and group neostigmine in itself, with vitamin D levels above and below 30 ng/mL. Statisticalanalysis was performed on these 4 groups (Group neostigmine and vitamin D < 30 ng/mL), (Group neostigmine and vitamin D ? 30ng/mL), ( Group sugammadex and vitamin D < 30 ng/mL), (Group sugammadex and vitamin D ? 30 ng/mL).When two responses to train of four (TOF) stimulation were taken, the following times were recorded until extubation phase. The timeuntil TOF value 50%, 70%, 90%, and extubation were recorded.Results: There were statistically significant differences between Group sugammadex and vitamin D < 30 ng/mL and Group sugammadexand vitamin D ? 30 ng/mL (P = 0.007) for extubation times and 50% TOF reach times (P = 0.015). However, there was no differenceobserved between Group neostigmine and vitamin D < 30 ng/mL and Group neostigmine and vitamin D ? 30 ng/mL (P = 0.999).Conclusion: Vitamin D deficiency is important for anesthesiologists in terms of muscle strength and extubation time. Vitamin Ddeficiency seems to affect sugammadex reverse times but seems not to affect neostigmine reverse times. This conclusion needs furtherstudies.Öğe The effectiveness of preemptive analgesic techniques on postoperative analgesia in patients undergoing open septorhinoplasty(Kare Publ, 2016) Keskioğlu, İlknur; İnal, Meltem Aktay; Özlü, OnurObjectives: A comparison was made of effects of preincisional intravenous (IV) dexketoprofen trometamol and acetaminophen on postoperative pain, analgesic requirement, hemodynamic parameters, postoperative tramadol consumption, and patient satisfaction in patients undergoing elective septorhinoplasty. Methods: Sixty patients scheduled for elective septorhinoplasty under general anesthesia were divided into 3 groups. Groups were similar with respect to gender, mean age, body weight, mean duration of surgery and anesthesia (p > 0.05). Group D (n = 20) received 50 mg IV dexketoprofen trometamol, while Group A (n = 20) received 1 gr IV acetaminophen before surgical incision. Group K (n = 20) received no analgesic. Postoperative analgesia was maintained with IV tramadol infusion, with the aid of patient-controlled analgesia pump. Visual analogue scale (VAS), total tramadol consumption, and patient satisfaction were recorded at 15 and 30 minutes postoperatively, as well as 1, 2, 6, 12, and 24 hours postoperatively. Results: VAS values were highest in Group K and lowest in Group D (p < 0.001). There was no difference in tramadol consumption between Group K and Group A, but both groups consumed higher doses of tramadol than Group D (p = 0.649 and p < 0.05, respectively). First analgesic requirement time and side effects were similar in all groups. Conclusion: It was observed that both preemptive IV dexketoprofen trometamol and acetaminophen were effective for postoperative analgesia in early postoperative period in elective septorhinoplasty under general anesthesia; however, preemptive dexketoprofen trometamol was more effective than acetaminophen for postoperative analgesia.Öğe Let us save the brain with cerebral oximeter: Two case reports(Wolters Kluwer Medknow Publications, 2017) Şeker, İlknur Suidiye; Özlü, Onur; Özkan, Aybars; Uzun, Hakan; Esbah, Ali Ümit; Çetin, PelinIn the neonates, tracheal atresia and tracheoesophageal fistula (TEF) surgery may result in hemodynamic instabilization, leading to cerebral perfusion insufficiency due to the retraction of the pulmonary vessels and truncus brachiocephalicus. We represented one male and one female neonates which were performed thoracoscopic primary repair of TEF through right thoracotomy at the 3th and 4th postpartum day. Anesthesia was induced using sodium thiopental (5 mg/kg), fentanyl 4 mcg, and rocuronium (0.5 mg/kg) given through intravenous route. Sevoflurane 2% and 50% O2in air were used for the maintenance therapy. During the right lung compression to expose posterior esophagus, no value was observed on the pulse oximeter (PO) probe placed on the right hand, and radial artery was not palpated. At the same time, oxygen saturation was observed as 96%-97% on the left foot probe. As the right cerebral oximeter values (rSO2) were rapidly decreased to 31%, the lung compression was ceased. Right pulse oximeter and right rSO2measurements return to the baseline levels. For the second case - different from the first case -both left and right rSO2was rapidly decreased to 40% levels and return to the baseline levels after was removed the retractors. Right PO and right and left cerebral rSO2values returned to baseline immediately when the retractor compression was ended During the operations involving the great vessels in neonates, cerebral perfusion could be preserved using cerebral oximeter. Cerebral oximeter is more efficient than pulse oximeter for detecting cerebral tissue oxygenation and could be helpful to minimize neuronal damage in the neonates. © 2019 African Journal of Paediatric Surgery | Published by Wolters Kluwer - Medknow.Öğe Locomotor stimulation by acute propofol administration in rats: Role of the nitrergic system(Polish Acad Sciences Inst Pharmacology, 2015) Tezcan, Aysu Hayriye; Özçetin, Ayşe; Özlü, Onur; Çevreli, Burcu; Uzbay, TayfunBackground: The addictive potential of propofol has been scientifically discussed. Drugs' psychostimulant properties that can be assessed via measurements of locomotor activity are linked to their addictive properties. No studies that have investigated the effects of propofol on locomotor activity have been reported to date. The present study sought to investigate the effects and possible mechanisms of action of propofol on locomotor activity in rats. Methods: Adult male albino Wistar rats (250-330 g) were used as subjects. The locomotor activities of the rats were recorded for 30 min immediately following intraperitoneal administration of propofol (20 and 40 mg/kg), saline or vehicle (n = 8 for each group). NG-nitro arginine methyl ester (L-NAME, 15-60 mg/kg), a nitric oxide (NO) synthase inhibitor, and haloperidol (0.125-5 mg/kg), a non-specific dopamine receptor antagonist, were also administered to other groups of rats 30 min prior to the propofol (40 mg/kg) injections, and locomotor activity was recorded for 30 min immediately after propofol administration (n = 8 for each group). Results: Propofol produced significant increases in the locomotor activities of the rats in the first 5 min of the observation period [F(2,21) = 9.052; p <0.001]. L-NAME [F(4,35) = 3.112; p = 0.02] but not haloperidol [F(4,35) = 2.440; p = 0.067] pretreatment blocked the propofol-induced locomotor hyperactivity. L-NAME did not cause any significant change in locomotor activity in naive rats [F(2,21) = 0.569; p = 0.57]. Conclusions: Our results suggest that propofol might cause a short-term induction of locomotor activity in rats and that this effect might be related to nitrergic but not dopaminergic mechanisms. (C) 2015 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Sp. z.o.o. All rights reserved.Öğe The postoperative respiratory failure due to vocal cord polyp in laparoscopic bariatric surgery: A case report [Laparoskopik bariyatrik cerrahide vokal kord polibine ba?li postoperatif solunum yetmezli?i: Olgu sunumu](Anestezi Dergisi, 2015) Şeker, İlknur Suidiye; Sezen, Gülbin; Özlü, Onur; Güçlü, EnderObesity is a major risk factor of difficult intubation and mask ventilation during induction of anesthesia. Because of the obesity, the degree of concomitant lung and upper airway pathologies increase the obstructive and restrictive disorders of the airway functions. In this case the airway management of patient who had sleeve gastrectomy operation is presented. It was predicted to be a difficult intubation on the preanesthetic examination and also vocal cord polyps were established during the endotracheal intubation with fiberoptic bronchoscope under general anesthesia.Öğe Re: Passive Smoking Also Affects Recovery from Anaesthesia Reply(Aves, 2017) Öztürk, Ömür; Sezen, Gülbin Yalçın; Ankaralı, Handan; Özlü, Onur; Demiraran, Yavuz; Ateş, Hakan; Dost, Burhan…Öğe Re: The Negative Influence of Cigarette Smoke on Passive Smokers-Deteriorated Pulmonary Function Tests and Increased Urine Cotinine Levels(Aves, 2019) Öztürk, Ömür; Sezen, Gülbin Yalçın; Ankaralı, Handan; Özlü, Onur; Demiraran, Yavuz; Ateş, Hakan; Dost, Burhan…Öğe Relationship between Trigeminocardiac Reflex, QT, QTc and Anesthesia in Septorhinoplasty Surgeries(2020) Konuk, İ Smail Doğan; Yorulmaz, İlknur; Özlü, Onur; Özçelik, Derya; Akcan, Fatih; Çetin, PelinObjective: Trigeminocardiac reflex is a reflex characterized by hypotension, bradycardia,gastric hypermotility or asystole that develops as a result of stimulation of the trigeminalnerve. In our retrospective study, in septorhinoplasty operations performed under generalanesthesia, trigeminocardiac reflex development was investigated primarily during theperiods where the reflex was surgically stimulated. Secondly, the effect of different inhalationanesthetic agents on the emergence of this reflex was investigated.Methods: Anesthesia notes and Datex Ohmeda icentral central monitor records ofseptorhinoplasty cases operated between 01 / January / 2016 - 30 / November / 2016 wereretrospectively examined and detected through the Hospital Information Management Systemsoftware. Induction, application of local anesthesia, surgical incision, initiation of incisionsuturing and 5 minutes after extubation were recorded from the records. It was determinedthat two different inhalation anesthetics were administered in 60 patients who met the criteria,and analyzes were performed in 2 separate groups as group sevoflurane and group desflurane,and the development of QT, QTc and Trigeminocardiac reflex was investigated.Results: Although there was no difference between the groups, when the basal values werecompared with the other periods, it was found that the development of TKR and QT and QTcexperts were mostly observed in the periods of local anesthesia, surgical incision and incisionsuturing. (p <0.001).Conclusions: We think that the inhalation anesthetic agents used mostly in the sevofluranegroup play a facilitating role in the development of TKR, especially by creating a cumulativeeffect during periods when the trigeminal nerve is maximally stimulatedÖğe Sigara Kullanımının Nöromuskuler Bloğun Geri Döndürülmesi Üzerine Etkisi(2016) Öztürk, Ömür; Sezen, Gülbin Yalçın; Ankaralı, Handan; Özlü, Onur; Demiraran, Yavuz; Ateş, Hakan; Dost, BurhanAmaç: Rokuronyum orta etki başlama süresine sahip, aminosteroid yapıda non depolarizan steroid kas gevşeticidir ve ideal kas gevşetici bulma çabaları sonucunda klinik amaçlı kullanılmaya başlanmıştır. Postoperatif kürarizasyon (PORC) non-depolarizan kas gevşeticilerin etkisinin uzaması sonucu ortaya çıkar. Bu önemli sorun günümüzde hala yaygındır ve hasta güvenliğini ciddi bir şekilde etkilemektedir. Literatür taramamızda sigara içiminin nöromuskuler bloğun etkisini ortadan kaldırmak ve PORC'dan kaçınmak için daha sık kıllanılan sugammadex üzerine etkisini araştıran bir çalışma bulunmamıştır. Bu çalışmanın amacı sigara kullanımının rokuronyum bromürü antagonize etmek için kullanılan sugammadexin etkinliği üzerine etkisini araştırmaktır. Yöntemler: Prospektif randomize çalışmaya ASA 1-2; son 10 yıldır sigara içen veya hiç içmeyen elektif cerrahi hazırlığı yapılan hastalar dahil edildi. Hastalara rutin vital bulgu monitorizasyonu ve nöromuskuler monitörizasyon uygulandı. Anestezi indüksiyonunda 2 mg kg-1 propofol, 1 mcg kg-1 fentanyl IV verildi. Kornea refleksi kaybolduktan sonra 0,6 mg kg-1 rokuronyum bromur IV uygulandı. Dörtlü uyarı (TOF) 2 düzeyine ulaşıldığında hastalar entübe edildi. İdame %50 O2 , %50 hava ve %2 sevoflurane ile sağlandı. TOF 2 olduğunda 0,5 mg kg-1 rokuronyum bromür uygulandı. Operasyon sonunda 2 mg kg-1 sugammadeks uygulandı. TOF değerinin 0,7-0,8-0,9 olma süreleri kaydedildi. Bulgular: Sigara içenlerde entübasyon süresi 132,846,4 sn, iç- meyenlerde 127,632,7 sn bulundu. Sugammadeks uygulandıktan sonar sigara içenlerde TOF 0,7 153,354,7 sn ile içmeyenlerde 12567,2 sn bulundu. TOF 0,8'e ulaşma süresi sigara içenlerde 178,458,8 ile içmeyenlerde 146,672,6 sn bulundu. TOF 0,9'a ulaşma süresi sigara içenlerde 200,855,8 sn iken sigara içmeyenlerde 170,477,8 sn bulundu. Sonuç: İstatistiksel olarak anlamlı olmasada TOF süreleri sigara içenlerde daha uzun bulundu. Sigara kullanımının sugammadeks kullanımı üzerine etkisinin araştırılması için daha geniş örneklem gruplarında yapılan çalışmalara ihtiyaç vardır.Öğe An unexpected challenging airway: Urticaria factitia caused difficult mask ventilation and tracheal intubation(Elsevier Science Inc, 2019) Özlü, Onur; Yorulmaz, İlknur Suidiye; Esbah, Ali Ümit; Er, Uygur…
