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Öğe Anaesthetic management of an extremely obese woman undergoing open gastric bypass(Lippincott Williams & Wilkins, 2006) Akbay, Buket Kocaman; Hayıt, Feray; Pehlivan, Mevlüt; Ağartan, Canan…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 Comparison of costs and efficacy of intravenous and orally disintegrating ondansetron tablet as a prophylactic antiemetic therapy in major gynecologic operations(2005) Demiraran, Yavuz; Özdemir, İsmail; Akbay, Buket Kocaman; Hayıt, Feray; Demirci, FuatObjective: The aim of the study is to compare the antiemetic efficacy and costs of oral rapid disintegrating ondansetron tablets and intravenously administered ondansetron in patients undergoing major gynecologic surgery. Materials and Methods: Anesthesia was induced with thiopenthone, vecuronium and fentanyl. Nitrous oxide and sevoflurane were used to maintain anesthesia. Patients were prospectively randomized into three groups of 30 patients each, receiving either ondansetron 8 mg intravenously or saline infusion only or oral rapid disintegrating tablets of 8 mg ondansetron. The patients were evaluated for nausea and vomiting at 1st, 5th, 10th, 20th, 30th, 60th, and 120th minutes and 6th hours postoperatively. Results: There were no significant differences in adverse effects between placebo group, intravenous ondansetron group and oral ondansetron group (P>0.05). The incidence rates of nausea, vomiting and the need of metoclopropamide were higher in placebo group than intravenous and oral ondansetron groups (P<0.05). Conclusion: Postoperative nausea and vomiting are common during recovery from general anesthesia. Both oral and intravenous forms of ondansetron are efficacious in the prevention of this postoperative nausea and vomiting. Orally disintegrating tablets are inexpensive and may be administered more easily than the intravenous form of ondansetron. Therefore, oral ondansetron tablet may be an alternative to intravenous ondansetron infusion for postoperative nausea and vomiting after major gynecologic operations.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 Comparison of sevoflurane and halothane on induction and recovery in pediatric patients(2004) Şerifsoy, Talat Ercan; Demiraran, Yavuz; Çelikel, N.; Akbay, Buket KocamanIn this study, the effects of sevoflurane and halothane on induction and emergence and were compared. The study enrolled 60 ASA I-II pediatric patients aged between 0-12 years. They received no premedication and were randomized into two groups, one of which received sevoflurane anesthesia (S) and the other halothane anesthesia (H). Each of these volatile anesthetics were adminisrated in 33% oxygen and 67% nitrous-oxide mixture, in increasing doses. When the eye-lash reflex disappeared, the volatile anesthetic concentration was kept constant for four and a half minutes to complete the induction of anesthesia, until the patients were intubated. Following intubation, the volatile anesthetic dose was reduced to 1-1.5 MAC for maintenance. At the end of the surgical procedure, all volatile anesthetics were stopped and 100% oxygen was administrated. During induction, the time between the beginning of the administration of the volatile anesthetic to the patient and the loss of the eye-lash reflex was recorded. During recovery, the time between the beginning of application of 100% oxygen and the first swallowing reflex, the first leg-pulling, the extubation time and the time of crying were noted. There were statistically significant difference the first leg-pulling times between the two groups. Laryngospasm was observed in two patients in Group H, vomiting was observed in one patient in Group H and 3 patients in Group S. The utilisation of sevoflurane in the pediatric patiens may be safer than halothane in terms of having shorter recovery time and no laryngospasm during the induction.Öğe Effects of sevoflurane and TIVA with propofol on middle ear pressure(Elsevier Ireland Ltd, 2006) Öztürk, Özcan; Demiraran, Yavuz; İlçe, Zekeriya; Akbay, Buket Kocaman; Güçlü, Ender; Karaman, EminObjective: To evaluate the effects of sevoflurane and TIVA with propofol on middle ear pressure and to show the importance of anesthesia without using any inhalational agents during middle ear surgery. Study design: A prospective, randomized controlled clinical study. Methods: In this study, 25 male children that were scheduled for circumcision were randomised into two groups. Group I (n = 13) received TIVA with propofol and group II (n = 12) received sevoflurane. Baseline tympanometry reading was performed on each ear just before anesthesia. The next tympanometry reading was taken 10 min after applying the laryngeal mask. Data were analysed by Mann-Whitney U (between groups) and Wilcoxon tests (within groups). Results: Mean MEP values in 26 ears of 13 boys in group I did not show any significant difference before and after the anesthesia with propofol (p > 0.05). In group II mean MEP values in 24 ears of 12 boys showed a significant increase after the anesthesia with sevoflurane (p < 0.001). No significant difference was found between the MEP values of the two groups before the anesthesia (p > 0.05), and MEP values measured during the anesthesia were significantly higher in group II (p = 0.007). Conclusion: Sevoflurane may increase the middle ear pressure and TIVA with propofol may be used in middle ear operations more safely than sevoflurane. (C) 2006 Elsevier Ireland Ltd. All rights reserved.Öğe Efficacy of Topical Levobupivacaine in Control of Postoperative Pain after Septoplasty(Bmc, 2010) Yılmaz, Süleyman; Akbay, Buket Kocaman; Yıldızbaş, Şahnur; Güçlü, Ender; Yaman, Hüseyin; Sezen, Gülbin YalçınObjective: To search the efficacy of using Merocele (Medtronic, Minneapolis, MN) soaked with 5 mL of levobupivacaine hydrocloride as a nasal pack in control of postoperative pain after septoplasty. Design: The study was designed as a prospective, double-blind, randomized, controlled study. Forty-one patients who underwent septoplasty operation were included in the analysis. Setting: A tertiary referral hospital in Turkey. Material and Methods: Forty-one patients undergoing septoplasty were divided into two groups. At the end of the operation, Merocele packs were placed inside the nasal cavity. In the levobupivacaine group, each Merocele pack was soaked with 5 mL of levobupivacaine hydrochloride (25 mg/10 mL), and in the control group, Merocele packs were soaked with 5 mL of saline. Main Outcome Measures: Postoperative pain levels were recorded using a visual analogue scale (VAS score, 0-100) at 30 minutes and 1, 2, 8, 12, and 24 hours. Results: We did not find any significant difference between groups regarding age, gender, American Society of Anesthesiologists status, and body mass index. Postoperative VAS values at 30 minutes and 1, 2, 8, and 12 hours were significantly lower in the levobupivacaine group compared with the control group (p < .05). The need for supplemental analgesia was significantly lower in the levobupivacaine group compared with the control group (p < .01) Conclusion: Postoperative pain after septoplasty owing to nasal packing is an important problem, and using levobupivacaine-soaked Merocele as a nasal pack after septoplasty is an effective method for the control of this pain. It is a very easy, effective, and quick method and it improves patient comfort after septoplasty.Öğe Emergency thoracic epidural anesthesia with ropivacaine for a cachectic geriatric patient with ileus(2006) Akbay, Buket Kocaman; Hayıt, Feray; Özaydın, İsmet; Zengin, Ahmet; Demiraran, YavuzObjective: Operations associated with increased risk of perioperative mortality and morbidity lead to consider regional anesthesia techniques for elderly patients. Epidural analgesia is used widely combined with general anesthesia. In this case, it is discussed whether solely thoracic epidural technique with ropivacaine provide appropriate anesthesia or not in emergency situations for elderly patients. Case Report: A 73-year-old cachectic male diagnosed with ileus was scheduled for an emergency laparotomy. He had congestive heart failure with hypertension, tachycardia and tachypnea with jugular venous distension. Thoracic epidural anesthesia were performed with ropivacaine 75 mg. Total colectomy and ileorectal anastomosis were performed. The patient discharged uneventful postoperatively. Conclusion: Epidural anesthesia with ropivacaine was provided fast and effective anesthesia without sedation in the elderly patient with ileus. This technique should be used safely especially with it's advantages for cardiovascular and pulmonary compromised elderly patients.Öğe Subanesthetic concentration of sevoflurane and desflurane were inhalated in rats; Liver and kidney toxicities and behavioural effects(2007) Sezen, Gülbin; Demiraran, Yavuz; Akbay, Buket Kocaman; Aksoy, K.A.Aim: Numerous studies have suggested that chronic exposure to trace levels of anesthetic gas is harmful to operating room personel. In this study, we aimed to the effects of subanesthetic doses of sevoflurane and desflurane on anxiety and hepatic and renal toxicities according to biochemical and histopathological changes in rats. Material and Methods: Total 24 rats were included study and three groups were formed as sevoflurane (% 0.1), desflurane (% 0.04) and control (3 L min -1 O 2). During four months, every day between 09.00-13.00 hours in the morning were inhaled with anesthetic agent determined concentrations. Anxiety were examined with Plus Maze Test; pre and post study urea, BUN, creatinine and GGT were examined in blood supplies. At the end of the study, rats were sacrificed for examined of kidney and liver histopathologically. Results: In the sevoflurane and desflurane groups increased the time spent within the closed pathways without motion. In the sevoflurane group; GGT, urea and BUN levels were elevated significantly. In the sevoflurane and desflurane groups hepatic congestion were examined significantly increased more than control group, focal necrosis increased in the sevoflurane group more than others. In the sevofluran group; focal lymphocytic infiltration and flatting in the tubuler epithelium were examined significantly higher than other groups. Conclusion: Our results were examined, subanesthetic doses of sevoflurane and desflurane were used increased to anxiety, caused of renal and hepatic damage at subclinic levels in rats.Öğe Use of the bispectral index to predict a positive awareness reaction to laryngeal mask airway-Fastrach insertion and intubation(Wiley, 2007) Akbay, Buket Kocaman; Demiraran, Yavuz; Sezen, Gülbin; Akçalı, Gülgün Elif; Somunkıran, AslıAim: To determine whether the bispectral index (BIS) can be monitored to predict and indicate an awareness reaction to laryngeal mask airway-Fastrach (LMA-Fastrach) insertion and intubation at BIS values between 40 and 60. Methods: Fifty-one American Society of Anesthesiologists' (ASA) class I or II status patients aged over 20 years were included in this study. Midazolam 0.1 mg/kg was given for pre-medication, 30 min before induction. For induction, a 0.1-mu g/kg bolus injection of remifentanil was followed by infusion, and propofol was administered until the eyelash reflex disappeared; the infusion rate was adjusted to maintain BIS values between 40 and 60. Loss of the eyelash reflex, loss of response to verbal commands, yawning and total propofol consumption were recorded. Patients were tested for awareness twice at 1-min intervals using the isolated forearm technique. The test was considered to be positive if the patient squeezed a hand when asked; after muscle relaxation, the patient was intubated and the test was repeated. In the recovery room and ward, patients were asked whether they could recall this event. Results: Seven patients tested positive: two following LMA-Fastrach insertion and the remaining five following intubation. None of the patients had recall. Conclusion: Awareness during anaesthesia may occur at BIS levels that indicate adequate anaesthesia, but this is not associated with recall of the events later.