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Öğe Acute respiratory İnsufficiency due to peripartum cardiomyopathy after caesarean section in a term pregnancy with twins(2010) Demiraran, Yavuz; İskender, Abdülkadir; Ersoy, Özlem; Albayrak, Mustafa; Kaynak, Gürselİkiz gebeliği olan ve postoperatif dönemde kardiyomiyopatiye bağlı akut solunum yetmezliği gelişen bir olgu sunulmuştur. Bizim olgumuzda, 30 yaşında 32 haftalık ikiz gebeliği olan kadın hasta preterm membran rüptürü nedeniyle Kadın Hastalıkları ve Doğum kliniğine yatırıldı. Tokolizden 48 saat sonra genel anestezi altında hasta operasyona alındı. Uyandırma döneminde SpO2 %32 saptanan hastada taşikardi ve takipne gelişti. Oskültasyonda her iki akciğer alt zonda krepitan raller tespit edildi. Hasta pozitif basınçlı ventilasyona rağmen oksijen satürasyon yüzdesinin düşük seyretmesi ve siyanozunun devam etmesi nedeniyle, Yoğun Bakım Ünitesi’ne entübe halde alındı. Çekilen akciğer grafisinde, her iki akciğer alt loblarında pulmoner infiltratlar ve kalp gölgesinin genişlemiş olduğu tespit edildi. Ekokardiyografik incelemesinde ejeksiyon fraksiyonu %45, sol ventrikül sistolik disfonksiyonu, sol ventrikül boyutlarında artma, orta mitral kapak yetmezliği ve hafif triküspit kapak yetmezliği saptanan hastada, bu tabloyu açıklayacak anemi dışında bulgu saptanmadı. Peripartum kalp yetmezliği tanısı konan hastaya lisinopril ve furosemid başlandı. Postoperatif 4. günde hasta mekanik ventilatörden ayrıldı, postoperatif 7. günde taburcu edildi.Öğe Adding intrathecal morphine to unilateral spinal anesthesia results in better pain relief following knee arthroscopy(Springer Tokyo, 2008) Demiraran, Yavuz; Yücel, İstemi; Akçalı, Gülgün Elif; Değirmenci, Erdem; Sezen, Gülbin; İskender, AbdülkadirIntrathecal morphine is administered to provide profound and prolonged analgesia, and to treat acute postoperative pain. We compared the effectiveness of hyperbaric bupivacaine alone and in combination with morphine for unilateral spinal anesthesia in patients undergoing knee arthroscopy. Sixty patients were randomly allocated to two groups to receive either 1.2 ml (6 mg) of 0.5% hyperbaric bupivacaine (group B; n = 30) or 1.2 ml of 0.5% hyperbaric bupivacaine containing 0.16 mg of morphine (group BM; n = 30). Spinal block was assessed by pinprick and a modified Bromage scale and compared between the operated and nonoperated sides. Visual analog scale (VAS) values, duration of analgesia, and total analgesic requirement of patients were recorded. Patients in group BM had significantly lower VAS values on movement at 30 min and at 2, 4, 6, and 12 h postoperatively (P < 0.05 and P < 0.001, P < 0.001, P < 0.001, and P < 0.05, respectively). The total analgesic requirement in the first 24 h after surgery was significantly higher in group B (P < 0.001). Patients in group BM had a significantly longer duration of analgesia in the first 24 h postoperatively (P < 0.001). Motor blockade of the operated limb in group BM was similar to that in group B (P > 0.05), and motor blockade of the nonoperated limb in group BM was also similar to that in group B (P > 0.05). We conclude that unilateral spinal anesthesia with hyperbaric bupivacaine plus 0.16 mg morphine is preferable to hyperbaric bupivacaine alone with respect to analgesic requirement, duration of analgesia, and VAS values.Öğe Analgesic efficacy of topical tramadol in the control of postoperative pain in children after tonsillectomy(Springer Japan Kk, 2010) Akbay, Buket Kocaman; Yıldızbaş, Şahnur; Güçlü, Ender; Yılmaz, Süleyman; İskender, Abdülkadir; Öztürk, ÖzcanPain control after tonsillectomy is still a controversial issue. Topical approaches have the advantage of pain control with good patient acceptability. Therefore, this study was conducted to evaluate the effects of topical tramadol on postoperative pain and morbidity in children undergoing tonsillectomy. A prospective, randomized, double-blind, controlled clinical study was designed. Forty children aged between 4 and 15 years, ASA I-II, scheduled for elective tonsillectomy and/or adenoidectomy were randomized into two groups. For patients in Group T (n = 20) swabs soaked with 2 mg/kg tramadol diluted in 10 ml saline were applied to both of their tonsillar fossa for 5 min; in the control group (n = 20) swabs soaked with 10 ml saline were applied. Postoperative pain scores, bleeding, nausea, vomiting, abdominal discomfort, constipation, pain in the throat, painful swallowing, fever, otalgia, trismus, and halitosis were recorded at the first, fifth, thirteenth, seventeenth, twenty-first, and twenty-fourth postoperative hours and the week after tonsillectomy. Pain scores were found to be significantly lower at the 21st hour and on postoperative day seven in the tramadol group compared with the control group (p < 0.05). Mean daily pain scores ranged from Day 1: 0.34 (+/- 0.21) to Day 7: 0.11 (+/- 0.08) in the tramadol group and Day 1: 0.53 (+/- 0.14) to Day 7: 0.42 (+/- 0.15) in the control group. There were no significant differences in morbidity between the groups (p > 0.05). Topical 5% tramadol with its local anesthetic effect seems to be an easy, safe, and comfortable approach for pain management in children undergoing tonsillectomy.Öğe Can anti-adhesive efficacy of sodium hyaluronate and carboxymethylcellulose membrane be improved further by colchicine and collagenase?(Duzce University Medical School, 2011) Sarohan, Aziz Rodan; Albayrak, Mustafa; Somunkıran, Aslı; Özdemir, İsmail; İskender, Abdülkadir; Sezen, Gülbin Yalçın; Demiraran, YavuzAim: The aim of this study was to determine the impact of collagenase and colchicine in the prevention of postsurgical adhesion formation in a rat uterine horn model. Materials and Methods: Forty female Wistar albino rats were divided into four equal groups including controls, seprafilm, colchicine-seprafilm and collagenase-seprafilm groups. After laparotomy, a standard 0.5-cm injury was made to the antimesosalpingeal side of the right proximal uterine horn by unipolar cautery. After hemostasis, 0.5 cm seprafilm or colchicine 2 mg-0.5 cm seprafilm or collagenase 1?g - 0.5 cm seprafilm was applied to the site of injury. The abdominal incision was then sutured en bloc and the rats were observed for 20 days. Then, all rats were sacrified and second look laparotomy was performed. Macroscopic adhesion score of each rat was noted and histopathologic scoring was made according to Kanbour-Shakir criteria. Results: All of the five scores of the histologic parameters were lowest in the colchicineseprafilm group. The total histologic score of colchicine-seprafilm group was significantly lower than controls, seprafilm and collagenase-seprafilm groups (p<0.05). Conclusions: The results of this rat model suggested that local use of colchicines in the abdominal operations prevents formation of postsurgical adhesions based on both visual assessment and histological analyses. The promising result obtained from this experimental study needs further investigation. © 2011 Düzce Medical Journal.Öğe Can anti–adhesive efficacy of sodium hyaluronate and carboxymethylcellulose membrane be improved further by colchicine and collagenase?(2011) Sarohan, Aziz Rodan; Albayrak, Mustafa; Somunkıran, Aslı; Özdemir, İsmail; İskender, Abdülkadir; Sezen, Gülbin Yalçın; Demiraran, YavuzAmaç: Cerrahi sonrası intraperitoneal adezyonların oluşumunu önlemede kollajenaz ve kolşisinin etkinliklerini deneysel hayvan modelinde histopatolojik değerlendirme ile araştırmaktır. Gereç ve Yöntem: Çalışmada 40 adet dişi Wistar Albino cinsi rat kullanıldı. Ratlar, kontrol, seprafilm, kolşisin-seprafilm, kollajenaz-seprafilm olmak üzere dört gruba ayrıldı. Laparotomi ile sağ proksimal uterin horn antimezosalpingeal yüzde bisturi aracılığı ile 0.5 cm’lik bir kesi oluşturuldu. Takiben kesi üstüne deneklerin grubuna uygun olarak 0.5 cm’lik Seprafilm; 2 mg Kolşisin emdirilmiş 0.5 cm’lik Seprafilm; 1?g kollajenaz emdirilmiş 0.5 cm’lik Seprafilm yerleştirilerek batın kapatıldı. Kontrol grubuna herhangi bir ajan uygulanmadı. Ratlar 20 gün sonra sakrifiye edilerek makroskopik ve histopatolojik değerlendirmeleri yapıldı. Histopatolojik inceleme Kanbour-Shakir kriterlerine göre yapıldı. Bulgular: Histopatolojik olarak değerlendirilen beş parametrenin toplamı ile elde edilen histolojik toplam skorun kolşisin-seprafilm grubunda en düşük olduğu görüldü. Kolşisinseprafilm grubunun total histolojik skoru ile kontrol, seprafilm ve kollajenaz-seprafilm gruplarının ortalama histolojik skorları arasında istatistiksel olarak anlamlı ölçüde farklılık bulundu (p0.05). Sonuç: Batın içi operasyonlarda kolşisinin uzun süre lokal olarak etki etmesini sağlayacak bir metod ile kullanımı, cerrahi sonrası adezyon oluşumunu hem makroskopik hem de histolojik olarak azaltmaktadır. Bu deneysel çalışmadan elde edilen umut verici sonuçların araştırılacağı daha geniş kapsamlı çalışmalara ihtiyaç vardır.Öğe Comparison of effects on the oxidant/antioxidant system of sevoflurane, desflurane and propofol infusion during general anesthesia(Elsevier Science Inc, 2015) Erbaş, Mesut; Demiraran, Yavuz; Yıldırım, Hayriye Ak; Sezen, Gülbin; İskender, Abdülkadir; Karagöz, İbrahim; Kandiş, HayatiBackground and objectives: Desflurane and sevoflurane are frequently used for maintenance of anesthesia and studies have shown that these anesthetics cause a variety of changes to the oxidative stress and antioxidative defense mechanisms. This study aims to compare the effects of sevoflurane, desflurane and propofol infusion anesthesia on the oxidant and antioxidant systems of patients undergoing laparoscopic cholecystectomy. Methods: 45 patients between 18 and 50 years with planned laparoscopic cholecystectomy under general anesthetic were included in the study. Patients were divided into three groups on the way to surgery: propofol (group P n: 15), sevoflurane (group S n: 15) and desfiurane (group D n: 15). All groups were given hypnotic 2 mg/kg propofol IV, 1 mcg/kg fentanyl IV and 0.1 mg/kg vecuronium IV for induction. For maintenance of anesthesia group S were ventilated with 2% sevoflurane, group D cases were given 6% desflurane and group P were given propofol infusions of 12 mg/kg/h for the first 10 min, 9 rrig/kg/h for the second 10 min and 6 mg/kg/h after that. Before induction and after the operation venous blood samples were taken to evaluate the levels of glutation peroxidase, total oxidants and antioxidants. Results and conclusions: The 45 patients included in the study were 22 male and 23 female patients. The demographic characteristics of the groups were similar. In the postoperative period we observed that while sevoflurane and propofol increased antioxidants by a statistically significant level, desfiurane increased the total oxidants level by a significant amount compared to levels before the operation. (C) 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.Öğe A comparison of intrathecal sufentanil combined with either hyperbaric bupivacaine or hyperbaric ropivacaine for cesarean deliveries(2006) Hayit, F.; Demiraran, Yavuz; Sezen, Gülbin; Akbay, Buket Kocaman; İskender, Abdülkadir; Özdemir, I.Objective: In this study, we aimed to compare the motor and sensorial block characteristics, maternal and fetal effects, of intrathecal sufentanil combinations including either hyperbaric bupivacaine or hyperbaric ropivacaine in pregnant women undergoing spinal block for elective cesarean deliveries. Method: Sixty pregnant women between 18 and 40 years undergoing elective cesarean section were studied in a randomized prospective design. In group HBS, 12.5 mg hyperbaric bupivacaine and 5 ?g sufentanil in 3 mL serum physiologic was applied intrathecally in 30 of the women. In group HRS, 12.5 mg hyperbaric ropivacaine and 5 ?g sufentanil in 3 mL serum physiologic was applied intrathecally to the other 30. Results: In group HRS, the duration for reaching the maximum sensorial block was shorter in comparison to group HBS, although the difference was not statistically significant. The two-segment regression time was shorter in group HRS, when compared to group HBS. Motor block development time and motor block recovery time were statistically shorter in group HRS (p<0.05). Conclusion: Sufentanil combinations with either intrathecal hyperbaric bupivacaine or intrathecal hyperbaric ropivacaine can be used safely on patients undergoing cesarean deliveries.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 The early anti-inflammatory effect of Kefir in experimental corrosive esophagitis(Edizioni Luigi Pozzi, 2013) Yaşar, Mehmet; Taşkın, Ali Kemal; Kaya, Bülent; Aydın, Metin; Özaydın, İsmet; İskender, Abdülkadir; Kandiş, HayatiAim: Corrosive esophageal burns are still an important problem. The aim of this study was to evaluate the effect of kefir in an experimental corrosive esophagitis model. MATERIAL AND METHOD: Twenty-four male wistar albino rats were used in this experimental study. The rats were randomized into three groups according to the procedure and treatment type (each group has eight rats). Group I: (Control group), Group II: (Induction of corrosive esophagitis with 5 % NaOH without any treatment) and Group III: (Corrosive esophagitis treated with kefir). The rats were sacrificed on the first and seventh days. Mediastinum and abdominal cavity of rats were explorated. Approximately 1.5 cm of esophagus was removed for histopathological examination. Inflammation, injury in the muscularis mucosa and collagen deposition were evaluated. RESULTS: Histopathological results on the first day after caustic injury; inflammation was detected in three rats in Group II and there were no inflammation in rats in Group III. This difference was statistically significant (p<0.05). Injury in muscularis mucosa was detected in three rats in Group II and in one rat in Group III. Histopathological results on the seventh days after caustic injury; Inflammation was positive in four rats in Group II and three rats in Group III. Injury in muscularis mucosa was equal in two groups (three rats each). Collagen deposition with high grade (Grade 2) was detected in two rats in Group II and in four rats in Group III (p<0.05). CONCLUSION: Kefir has anti-inflammatory effect specially in early phase of caustic injury. It has also some beneficial effect in wound healing.Öğe Effect of anesthesiological strategies on neonatal bilirubin levels during cesarean section: a prospective and randomized trial(Springer Heidelberg, 2011) Demiraran, Yavuz; Albayrak, Mustafa; Şeker, İlknur Suidiye; Kaynak, Gürsel; İskender, Abdülkadir; Sezen, Gülbin Yalçın; Özdemir, İsmailPurpose Neonatal jaundice, a frequent problem in neonatology, can be influenced by many factors. Here, we sought to clarify the role of anesthesia and to compare the effects of various anesthesiological strategies on neonatal bilirubin levels during cesarean section. Methods We prospectively enrolled 167 ASA I-II status uncomplicated pregnant women who delivered by cesarean section as the study group. The patients were randomized based on anesthesiological strategy: inhalation (IA), spinal (SA), total intravenous (TIVA), and epidural anesthesia (EA) groups. Neonatal total (TB) and direct bilirubin (DB) levels at the 24th hour and 5th day of life and the need for phototherapy were compared between the groups. Results Direct bilirubin levels at 24th hour of SA group and EA group were higher compared to IA group (p = 0.008). When DB levels at fifth day were compared, levels in group TIVA were significantly higher than group SA (p = 0.019). TB levels at fifth day in group TIVA were higher than SA and EA groups (p = 0.05). The percentage of newborns needing phototherapy did not differ significantly among groups, but was highest in the TIVA group (25%), followed by the IA (15%), EA (10%) and SA (7%) groups (p = 0.08). Conclusions EA and SA at cesarean section seem to be better among the four anesthesia techniques considering neonatal hyperbilirubinemia. Our findings are consistent with the idea that anesthesia may be a risk factor for hyperbilirubinemia. Although anesthesia may not significantly increase the need for interventions such as phototherapy, it may increase the burden of time, labor and cost.Öğe Effects of desflurane on middle ear pressure(Elsevier Ireland Ltd, 2007) Öztürk, Özcan; İlçe, Zekeriya; Demiraran, Yavuz; İskender, Abdülkadir; Güçlü, Ender; Yıldızbaş, ŞahnurObjective: To evaluate the effects of desflurane on middle ear pressure. Study design: A prospective clinical study. Methods: In this study, 38 ears of 19 mate childrens that were scheduled for circumcision were included. Baseline tympanometry reading was performed on each ear just before anesthesia. After induction anesthesia with propofol a laryngeal mask was applied and desflurane administration was started. The next tympanometry reading was taken at 5th, 10th and 15th minute after administration and at the 10th minute after the cessation of desflurane. Data were analysed using Wilcoxon test. Results: Mean MEP values before anesthesia in 38 ears of 19 boys were -10.32 +/- 33.14. After starting the administration of desflurane 5th minute mean value was 71.15 +/- 60.42, at the 10th minute 111.56 +/- 59.03 and at the 15th minute it increased to 120.50 +/- 54.14, and these measurements were significantly higher than the starting value (p < 0.001). After cessation of desflurane mean MEP value dropped to 57.56 +/- 79.06, but compared with the starting value this was also significantly higher (p < 0.001). Conclusion: Desflurane may increase the middle ear pressure and it may be unsuitable for certain middle ear surgeries. (C) 2007 Elsevier Ireland Ltd. All rights reserved.Öğe The effects of topical levobupivacaine on morbidity in pediatric tonsillectomy patients(Elsevier Ireland Ltd, 2009) Yılmaz, Süleyman; Demiraran, Yavuz; Akkan, Nermin; Yaman, Hüseyin; İskender, Abdülkadir; Güçlü, Ender; Öztürk, ÖzcanObjective: To reduce the post-tonsillectomy morbidity by swab soaked with 5 ml levobupivacaine hydroclorur (25 mg/10 ml). Study design: A double-blind prospective randomized controlled clinical study. Methods: In this randomized double-blind study in group I (30 children, mean age 7.5 +/- 2.6) we tightly packed swab soaked with 5 ml levobupivacaine hydroclorur (25 mg/10 ml) and in group II (21 children, mean age 7.9 +/- 3.7) we used 5 ml saline swabs into each of the two tonsillar fossae after tonsillectomy for 5 min. We used McGrath's face scale to compare the two groups in respect of pain control. Results: There was statistically significant pain relieving effect in the levobupivacaine group in the first 24 h (p < 0.05). But after 24 h pain relieving effect of levobupivacaine was not significant (p > 0.05). We did not see any serious complications for both groups. Postoperative morbidity mean results (nausea, vomiting, fever, bleeding, halitosis and ear pain) were not statistically different between the two groups (P > 0.05). Conclusion: Topical levobupivacaine seems to be a safe and easy medication for postoperative pain control in pediatric tonsillectomy patients. (c) 2009 Elsevier Ireland Ltd. All rights reserved.Öğe Epidural anestezide %0.5 bupivakain ve % 0.5 levobupivakain kullanımının QT dispersiyonu ve hemodinamik etkilerinin karşılaştırılması(2010) Özdemir, Yaşar; Sezen, Gülbin Yalçın; Demiraran, Yavuz; Yazıcı, Mehmet; İskender, Abdülkadir; Yücel, İstemiAmaç: Bu çalışmanın amacı, epidural yolla uygulanan %0.5 bupivakain ile %0.5 levobupivakainin; hemodinamik ve QT dispersiyonu etkilerinin değerlendirilmesidir. Yöntem: Epidural anestezi ile operasyon planlanan 60 hasta çalışmaya dahil edildi. Randomize olarak 2 gruba ayrıldı; Grup B'de (n30) 15 mL %0.5'lik bupivakain, Grup L'de (n30) 15 mL %0.5'lik levobupivakain epidural yoldan uygulandı. Peroperatif dönemde sistolik kan basıncı (SKB), diyastolik kan basıncı (DKB), ortalama kan basıncı (OKB), kalp atım hızı (KAH), periferik oksijen satürasyonu (Sp02), solunum sayısı ve yan etkiler kaydedildi. Postoperatif dönemde motor blok geri dönüş süreleri 30 dk.'lık periyotlarla değerlendirildi ve total blok süreleri kaydedildi. Preoperatif, ilk epidural anestezi uygulamasından 30 dk. sonra ve postoperatif 24. saatte EKG çekildi ve bir kardiyolog tarafından değerlendirildi. Bulgular: Motor blok gelişimi ve total blok süreleri Grup B'de yüksekti (p0.05) ve 180. dk. OKB Grup B'de azalmıştı (p0.05). En uzun düzeltilmiş QT zamanı ve en kısa düzeltilmiş QT zamanı Grup B'de uzamıştı (p0.05). Hipotansiyon görülme sıklığında ise Grup B'de artış saptandı (p0.05). Sonuç: Kardiyak problemleri olan, daha az motor blokaj istenen hastalarda levobupivakainin bupivakaine iyi bir alternatif olabileceğini düşünmekteyiz.Öğe Evaluation of Outcomes in Patients Given Dexmedetomidine in Functional Endoscopic Sinus Surgery(Annals Publ Co, 2011) Güven, Damla Güçlü; Demiraran, Yavuz; Sezen, Gülbin; Kepek, Ökkeş; İskender, AbdülkadirObjectives: We aimed to evaluate the effects of dexmedetomidine hydrochloride (DEX) on hemodynamic parameters and on surgeon and patient satisfaction during functional endoscopic sinus surgery (FESS). Methods: Forty patients who were to undergo FESS were enrolled in this randomized, prospective, controlled study. In the DEX group, conscious sedation was induced with an infusion of 1 mu g/kg of DEX 10 minutes before surgery, followed by an infusion of DEX at 0.2 mu g/kg per hour. A control group was given identical amounts of saline solution. During the procedure, hemodynamic data were recorded. The patients evaluated their pain on a visual analog scale (VAS). Intraoperative bleeding was rated on a 6-point scale for evaluation of operative field visibility. Results: We observed that the DEX group had lower bleeding scores (p = 0.019). The heart rates were lower in the DEX group at the time of induction (p = 0.052) and in the 1st (p = 0.009) and 20th minutes (p = 0.039) of induction. The mean blood pressure values were lower in the DEX group in the 5th (p < 0.001), 45th (p = 0.003), and 60th (p = 0.05) minutes of induction. The VAS score was lower in the DEX group in the 30th postoperative minute (p = 0.001); however, the VAS score was lower in the control group after the 12th hour (p < 0.001). Postoperative side effects such as nausea, tachycardia, hypotension, and vomiting were significantly less frequent in the DEX group (p < 0.001). Conclusions: We observed that the intraoperative bleeding, hemodynamic stability, and VAS scores were better and the side effects were less frequent in the DEX group.Öğe An evaluation of the effect of dexmedetomidine on the haemodynamic response, quality of laryngoscopy and endotracheal intubation(2007) Demiraran, Yavuz; Sezen, Gülbin; Özer, Elif; Kocaman, Buket; İskender, AbdülkadirObjective: The aim of our study to evaluate effect of dexmedetomidine, which is used for premedication, on the quality of intubation and hemodynamic effects and to assess its effects on muscle relaxation by using neuromuscular monitorization. Method: A total of 48 patients between the ages of 18 and 55 were enrolled in the study. In Group D, 0.7 mcg kg-1 dexmedetomidine were given via infusion in 10 minutes, Group K was given a saline infusion. Neuromuscular monitorization was performed and the values were recorded before and after the induction. The quality of intubation was evaluated on the triple scale by an anesthesiologist. At the same time, heart rate and mean blood pressure values were recorded. Results: The mean blood pressure values were significantly lower in group K than in group D after the induction and muscle relaxant (p<0.05). When compared with group K, heart rate values in group D were found to be significantly lower during premedication, after induction, muscle relaxant and intubations. Compared with evaluation parameters, intubation quality and muscle relaxation were not significantly different. Conclusion: It was determined that there were no positive effects of dexmedetomidine HCl on the quality of intubation and muscle relaxation and an inhibition of the hemodynamic response was revealed after the intubation.Öğe Evaluation of the effects of desflurane and sevoflurane anesthesia on alveolar epithelial permeability by Tc-99m DTPA inhalation scintigraphy(Tubitak Scientific & Technical Research Council Turkey, 2013) İskender, Abdülkadir; Erkan, Melih Engin; Erbaş, Mesut; Güven, Damla Güçlü; Sezen, Gülbin; Aşık, Muhammet; Yıldırım, MustafaAim: Recently studies showed that volatile anesthetics affect the ciliary beat frequency in vitro. We know that impairment of ciliary beat frequency is related to a risk of pulmonary complications with general anesthesia. Other studies have also shown that exposure to a volatile anesthetic can increase the permeability of the alveolar-capillary barrier. The present study aimed to determine the effects of desflurane and sevoflurane anesthesia on the technetium-labeled diethylene triamine penta-acetic acid (Tc-99m DTPA) clearance rate of the alveolar epithelium. Materials and methods: A total of 40 patients who underwent elective tympanoplasty with general anesthesia were included in this study. Patients having any systemic disease or infection, or with any property that affected lung functions, were excluded from the study. Patients were randomized into 2 groups (20 patients in each) as receiving sevoflurane and desflurane. A Tc-99m DTPA aerosol inhalation lung imaging method was used to assess lung functions. Results: Demographic properties were similar in both groups. There were no significant differences between basal and postoperative lung clearance of inhaled Tc-99m DTPA in either group. Conclusion: We propose that neither sevoflurane nor desflurane induces pulmonary alveolar capillary injury in the acute period of general anesthesia based on Tc-99m DTPA scan results.Öğe Hipogliseminin Neden Olduğu Kortikal Laminar Nekroz(Düzce Üniversitesi, 2013) Haftacı, Engin; İskender, Abdülkadir; Erbaş, MesutKortikal Laminar Nekroz (KLN); genellikle serebral hipoksi, hipoglisemi veya iskemiden sonra g ouml;r uuml;l uuml;r. Elektif kolesistektomi operasyonu sonrasında akut solunum yetmezliği nedeniyle reanimasyon uuml;nitesine alınan ve takibi sırasında hipoglisemi atağının tetiklediği status epileptikus sonrası kortikal laminar nekroz gelişen 67 yaşındaki hasta sunulmaktadır.Öğe İkiz gebede posterior reversible ensefalopati sendromu ve anestezi yönetimi(2012) Erbaş, Mesut; Dost, Burhan; Öztürk, Ömür; İskender, Abdülkadir; Demiraran, YavuzPosterior reversible ensefalopati sendromu (PRES) baş ağrısı, mental bozukluk, epilepsi ve görme bozukluğu ile karakterize olup sıklıkla ani olarak yükselen ve kompanse edilemeyen arter basıncına bağlı olarak gelişir ve klinik ve radyolojik olarak tanı konulabilir. Son yıllarda literatürde değişik hasta popülasyonlarında, hastalığın tekrarladığına ait yayınlar giderek artmakla birlikte daha çok gebelerde postpartum dönemde görüldüğüne dair bilgiler mevcuttur. Bu makalede çoğul gebeliği olan ve preeklampsi tanısı mevcut olmayan nullipar bir gebede klinik ve nöroradyolojik bulguları ile reversible ensefalopati sendromu tanısı konulan olgusu sunulmakta ve literatür eşliğinde tartışılmaktadır.Öğe In vivo Comparison of the Effects of Bupivacaine and Levobupivacaine on the Pregnant Rat Myometrium Using Electrohysterogram(Karger, 2012) Kaynak, Gürsel; İskender, Abdülkadir; Albayrak, Mustafa; Ankaralı, Seyit; Demir, Şerif; Demiraran, Yavuz; Yalçın, Gülbin SezenBackground and Aims: The effect of local anesthetics on myometrial contractility during labor analgesia is debatable. We aimed to compare the effects of bupivacaine and levobupivacaine on rat uterine contractility in an in vivo setting. Methods: Electrical activities of 40 pregnant rat uteruses were recorded on electrohysterogram after dividing the rats into bupivacaine and levobupivacaine groups. Uterine contraction frequencies were recorded at each 5-min interval. The first 5-min recording was considered the control, which was immediately followed by intramyometrial administration of either bupivacaine or levobupivacaine. The recordings were continued for 30 min. The changes in frequencies at each time interval of the groups were compared with each other and the control recording. Results: The frequencies from both groups at each interval were lower than the control values, but not different between the groups. The frequencies of the bupivacaine group during the 5-10 min and 10-15 min intervals were lower than the control time interval, but no significant differences were present between the control and the other time intervals. However, no significant differences were found at any time interval for the levobupivacaine group. Conclusion: Levobupivacaine led to less muscle relaxation compared to bupivacaine and may be a better option for labor analgesia and anesthesia considering uterine contractility. Copyright (C) 2011 S. Karger AG, Basel
