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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 Does topical ropivacaine reduce the posttonsillectomy morbidity in pediatric patients?(Elsevier Ireland Ltd, 2008) Oğhan, Fatih; Harputluoğlu, Uğur; Güçlü, Ender; Kocaman, Buket; Öztürk, ÖzcanObjectives: To determine whether post-operative administration of topical ropivacaine hydrochloride decreases morbidity following adenotonsillectomy. Study Design: Prospective, randomized, double-blind clinical trial. Setting: University referral center; ENT Department. Participants: Fourty one children, aged 4-16 years, undergoing tonsillectomy. Methods: Patients received 1.0% ropivacaine hydrochloride soaked swabs packed in their tonsillar fossae while the control group received saline-soaked swabs. Mc Grath's face scale was used to compare the two groups in respect of pain control. Chi-square and two-tailed unpaired Student's t-tests or Mann-Whitney-U-tests were used to compare the two independent groups. As 10 we made 11 comparision between groups, for Bonferroni correction, p < 0.005 was accepted as statistically significant. Results: Only first hour there was no significant pain-relieving effect seen in the ropivacaine group (p > 0.05). The other hours and days there were statistically significance between the two groups (p < 0.001). Also, the other post-operative parameters such as nausea, fever, vomiting, odor, bleeding, otalgia and trismus were not statistically different between the two groups. There were no complications associated with ropivacaine hydrochloride. No patients in this study suffered systemic side effects related to the use of this medication. Conclusion: Locally 1.0% ropivacaine administiration significantly relieves the pain of pediatric tonsillectomy and, it is a safe and effective method. High concentrations of ropivaciane may produce clinically significant pain relief. It is more effective to reduce of post-operative analgesic requirement after first hour. (c) 2007 Elsevier Ireland Ltd. All rights reserved.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 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 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 (p
