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Öğe Anticholinergic Syndrome in a Pediatric Patient after Resuscitation(Düzce Üniversitesi, 2005) Demiraran, Yavuz; İskender, Abdulkadir; Kocaman, BuketCentral anticholinergic syndrome is considered to reveal after blocking of central and peripheral cholinergic muscarinic receptors. Although central anticholinergic syndrome can be diagnosed with its clinical signs, the definitive diagnose can be made according to the response with physostigmin administration. It is aimed to discuss the therapy of a child who revealed the clinical signs of central anticholinergic syndrome (agitation, mydriasis, excitation, tachycardia, flushing, and fever) after resuscitationÖğe Chronic Ossified Subdural Haematoma: A Case Report(Düzce Üniversitesi, 2013) Sarıtaş, Ayhan; Çalıkoğlu, Çağatay; İskender, Abdulkadir; Kandiş, Hayati; Aykanat, ÖmerChronic ossified subdural haematoma is seen very rarely. Chronic calcified subduralhaematoma may be seen in 0.3% to 2.7% of all chronic subdural haematoma cases. We havepresented a 34 year old female patient with chronic cacified subdural haematoma in leftfrontotemporal region causing compression of nearby tissue, admitting to our out-patient clinicwith the complaints of haedache, convulsions and rare syncopes. We have evaluated surgicalapproach in our patient and in the other cases with chronic calcified subdural haematoma inthe light of literature. We have seen that symptoms decrease in symptomatic patients withcerebral compression after surgical excision of calcified membraneÖğe Comparison of the effects of %0.5 bupivacaine and %0.5 levobupivacaine used for epidural anesthesia on QT dispersion and haemodynamy(2010) Özdemir, Yaşar; Sezen, Gülbin Yalçın; Demiraran, Yavuz; Yazıcı, Mehmet; İskender, Abdulkadir; Yücel, İstemiObjective: The aim of this study was to compare the hemodynamic variables and QT dispersion effects of 05% bupivacaine and 0.5% levobupivacaine using epidural via. Methods: Sixty patients scheduled for operation under epidural anesthesia were included to this study. The patients were randomized into two groups; 15 mL of 0.5% bupivacaine was given to Group B patients (n=30) and 15 mL of 0.5% levobupivacaine was given to Group L patients (n=30). Systolic blood pressure, diastolic blood pressure, mean blood pressure, heart rate, saturation of peripheral oxygen, respiratory rate and side-effects were recorded during perioperative period. Postoperatively, motor blockade recovery time was assessed at 30-minute inten'als and total motor blockade time was recorded. ECG was recorded at preoperatively, at 30 minutes after first epidural anesthetic and postoperatively 24-hour and was assessed by a cardiologist. Results: Motor blockade and total blockage time were found to be longer in Group B (p<0.05). Mean blood pressure at the 180th minute was found to be decreased in Group B (p<0.05). The longest corrected QT interval and the shortest corrected QT interval were increased in Group B (p<0.05). Incidence of hypotension was higher in Group B (p<0.05). Conclusion: Levobupivacaine can be preferred to bupivacaine in patients having cardiac problem and when less motor blockade is desired.Öğe Congenital Diaphragmatic Hernia with Late Diagnosis: A Case Report(Bolu Abant İzzet Baysal Üniversitesi, 2018) Karagöz, İbrahim; İskender, Abdulkadir; Köse, Gökçe AkmanCongenital diaphragmatic hernia CHD is a congenital anomaly characterized by an anatomical defect in the diaphragm, accompanied by various anomalies regarding cardiac, urogenital, chromosomal, genetic and skeletal system. It has not well-known etiology, and causes the intrauterine organs to enter the fetal thoracic cavity in the early stages of the lung development. Its mortality rate in live newborns varies between 10% and 35%. Although recurrent respiratory distress and atypical abdominal pain are commonly observed clinical manifestations in older patients, its prognosis is better than the patients diagnosed in the neonatal period. Its treatment can delay due to the difficulty of establishment of the diagnosis at the advanced age. The most classical form of CHD is encountered as a defect in the left posterolateral diaphragmatic area. The left lobe of liver, spleen and almost all gastrointestinal tract structures pass into the thoracic cavity from this defect. On the other hand, the right lobe of liver and other abdominal organs pass into the thoracic cavity from right-sided hernias. In these cases, hepatic veins can be opened ectopically to the right atrium, which may complicate surgical repair. In this paper, we presented a case of CHD who admitted to the emergency department with severe abdominal pain and diagnosed at lateterm, as well as our experience regarding the performed anesthesia methodÖğe Hypotension Prolonged in a Patient with Myasthenia Gravis after Epidural Anesthesia(Düzce Üniversitesi, 2005) Hipotansiyon, Uzun Süren; Demiraran, Yavuz; Özdemir, Yaşar; Elitaş, Önder; Kocaman, Buket; İskender, AbdulkadirMyasthenia gravis is a chronic autoimmune disease characterized by progressive weakness and easy fatigability of voluntary skeletal muscles. Clinicians are well aware of the risk of postoperative respiratory failure that may result from stress-induced exacerbation of Myasthenia gravis (myasthenic crisis), an overdose of anticholinesterases (cholinergic crisis), the residual effects of myorelaxants or other adverse drug interactions (with antibiotics or antiarrhythmics). Therefore, routine postoperative ventilatory support and planned extubation in the intensive care unit have been recommended in high-risk patients. However, regional anesthesia have been suggested for the lower abdominal and extremity operations. We wanted to report our case observing severe hypotension during and after operation in the patient with myasthenia gravis performing epidural anesthesia for radical prostatectomyÖğe Intraabdominal hemorrage due to acute pancreatitis: Case report(Duzce University Medical School, 2018) Yekenkurul, Erman; Yaşar, Mehmet; Yekenkurul, Dilek; İskender, AbdulkadirAcute pancreatitis is acute inflammation of pancreatic cells that may presents with non-specific findings such as abdominal pain and vomiting. Haemorrhage is a rare complication of acute pancreatitis, while complications such as pseudocyst, abscess, necrosis may also occur. Here, we present a case of 39-years-old male patient with intraabdominal bleeding due to idiopathic acute pancreatitis. Patient presented to emergency department with abdominal pain and lack of appetite; as a result of history, findings and investigations acute pancreatitis were considered. Oral feeding was stopped and nutritional support was given by vascular access and pain control was achieved. Due to decrease in hemoglobin and hemotacrit level diagnostic laparoscopy were performed. On exploration fragile and hemorrhagic pancreas was observed. Bleeding control was achieved; after symptomatic treatment abdominal pain regressed. Laboratory findings were completely recovered and patient was discharged. As a result; should also be noted that the rare complications of acute pancreatitis, such as hemorrhage,can be seen, so considering the patient's symptoms can mislead us further investigations should be made. © 2018, Duzce University Medical School. All rights reserved.Öğe Kısa süreli jinekolojik girişimlerde farklı sedo-analjezi yöntemlerinin karşılaştırılması(Kocaeli Derince Eğitim ve Araştırma Hastanesi, 2012) İskender, Abdulkadir; Erbaş, Mesut; Karagöz, İbrahimAMAÇ: Kısa süreli jinekolojik işlemler genellikle sedo-analjezi ile yapılmaktadır. Bu çalışmamızda günübirlik anestezi uygulanan bu küçük cerrahi girişimlerde sedo-analjezik olarak kullanılan propofol, etomidat ve ketaminin etkilerinin karşılaştırılmasını amaçladık YÖNTEMLER: Amerikan Anesteziyoloji Derneği (ASA) I-II risk grubu, 25-50 yaş arası toplam 75 hasta çalısmaya dahil edildi. hastalara operasyondan 30 dakika önce midazolam 0.04 mg/kg im premedikasyon amacıyla uygulandı. Grup P’ deki hastalara 0,5mg/kg propofol, grup E ‘deki hastalara 0,1mg/kg etomidat, Grup K’daki hastalara 0,5mg/kg ketamin IV bolus yapıldı. Hastaların Ramsey Sedasyon Skorları, uyanma zamanı, derlenmeye alınma süreleri, ek ilaç dozları, total ilaç miktarı, oluşan yan etkiler kaydedildi.BULGULAR: Propofol grubundaki hastaların %60’ında apne, %13.3’ünde hipotansiyon, %33.3’ünde bradikardi, %33.3’ünde enjeksiyona bağlı kolda ağrı,Etomidat grubundaki hastaların %6.7’sinda apne, %40’ınde bulantı-kusma, %33.3’ünde myoklonik hareketler, Ketamin grubundaki hastaların %6.7 ’sinde myoklonik hareketler, %13.3’ünde bulantı-kusma görüldü.SONUÇ: Hastaların hızlı ve rahat uyanmasını en iyi sağlayan etomidat-alfentanil grubu olmakla beraber ek hastalıkları göz önüne alınarak ilaçlar tercih edilmesi gerektiğini düşünüyoruzÖğe The Effects of Endotracheal Administration of N-Acetylcysteine on the Respiratory Functions(Düzce Üniversitesi, 2005) Demiraran, Yavuz; Annakkaya, Ali Nihat; Akçalı, Gülgün Elif; Yeşiloğlu, Reşat; Kocaman, Buket; Sezen, Gülbin; İskender, AbdulkadirIn this study, to investigate the effect on the per and postoperative respiratory complications of the administration of n-acetyl cystein as endotracheal during intubation to the smoker patients undergoing surgery was aimed. This study was planned as prospective, randomized, placebo controlled, double blinded and 40 patients as two groups. The study included between 20 to 60 years of age, ASA I-II, patients who were satisfied the following conditions; minimum 10 cigarettes per day for minimum 5 years and need to take general anesthesia. Chest radiography, respiratory functions test and arterial blood pressure of the patients were analyzed preoperatively. After intubation, 2 ml % 0,9 NaCl (normal saline) was given to group P (n=20) and 2 ml n-acetyl cystein was given to group N (n=20) via inside the intubation tube and for rapid absorption high pressure ventilation (20cmH2O) was applied several times. ECG, non - invasive arterial pressure, heart beat rate, peripheric arterial oxigen saturation and entidal carbondioxid were monitored. Blood pressure at 1 and 24 hours and respiratory function test and chest radiography at 24 hours were repeated post operative. Pre-operative FEV1/FVC in n-asetilcystein group was found significantly lower than placebo group (pÖğe The Effects of General and Spinal Anesthesia on Apgar scores, thyroid and liver functions of babies delivered with Cesarean Section(Düzce Üniversitesi, 2013) İskender, Abdulkadir; Karagöz, İbrahimPurpose: In our study we aimed to compare the Apgar scores, thyroid and liver functions ofneonates, who were delivered with elective caesarean section undergoing general anesthesia orspinal anesthesia.Methods: 60 patients with age 18–40 were included. Patients were randomized in 3 groups:general anesthesia inducted with propofol or with thiopenthal or spinal anesthesia. In propofolgroup induction was perf ormed with propofol 2 mg/kg and rocuronium 0,6 mg/kg and thenpatients were intubated. In thiopenthal group induction was performed with thiopental 4–5mg/kg and rocuronium 0,6 mg/kg and then patients were intubated. In both groups anesthesiamaintenance was provided with sevoflurane. In spinal anesthesia group, spinal anesthesia wasperformed with bupivacaine intrathecally. In all 3 groups maternal haemodynamic parametersat zero, 5, 10, 15, 20, 25, 30, 35, 40, 45 th minutes were recorded. When the neonate is 5 daysold, tyroid functions and liver functions were evaluated.Results: In thiopenthal group, FT3 values of neonates were significantly decreased (pÖğe The Effects of Remifentanil Infusion and Intermittent Propofol Practices on Hemodynamic and Recovery Time During Colonoscopy(Düzce Üniversitesi, 2013) Şavluk, Ömer Faruk; Yılmaz, Edip Erdal; Dost, Burhan; İskender, Abdulkadir; Erbaş, MesutObjective: In the present study, we evaluated the effectiveness of intermittent remifentaniland propofol infusion on hemodynamic effects, side effects, recovery times, leaving thehospital period and the physician and patient satisfaction in sedo-analgesia practices.Methods: After institutional approval and informed consent, sedo-analgesia with 0,025µg/kg/dk remifentanil continuous infusion were performed in 54 ASA I-III patients forcolonoscopy. After two minutes infusion of remifentanil, propofol 0,5 mg/kg was infused ashypnotic medicine. 0,25 mg/kg propofol intravenous added if additon doses are needed. Duringthe colonoscopy ,the total propofol dose, colonoscopy time, anesthesia time, wake up timeand recovery time were recorded.Results: The mean age of the 54 patients in the study was 49,8 , 38 (71%), of thepatients were male and 16 (29%) of the patients were female. Colonoscopy was performedfor diagnosis in 42 patients and for follow-up in 12 patients. 5 (9%) of our patients hadhypotension, 4 (7,2%) patients had apnea, 3 (5%) of them developed bradycardia and 10(18%) of the patients had arm pain releated infusion. During colonoscopy, the mean of wakeup time was 6.4 min, and the mean of recovery time was 28.5 minutes.Conclusion: In this article due to short effects, less side effects and antiemetic features ofpropofol, we think it can be used as intermittent infusion in sedation for colonoscopy. Alsoremifentanil infusion with propofol has the potential advantages of reducing amounts ofintravenous propofol, less likelihood of problems from drug side-effects and fast recovery anddischarge time
