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Öğe Abant İzzet Baysal Üniversitesi Sağlık Araştırma ve Uygulama Merkezi'nde çalışan hekimlerin kardiyopulmoner resusitasyon konusundaki yaklaşımları(Aves, 2016) Yoldaş, Hamit; Koçoğlu, Hasan; Bayır, Hakan; Yıldız, İsa; Akkaya, Akçan; Demirhan, AbdullahObjective: We aimed to evaluate the attitudes of doctors about cardiopulmonary resuscitation (CPR) in this research. Methods: Overall, 234 doctors who were working in Abant Izzet Baysal University Health Research and Application Center and who accepted to participate in this research were included. Research data were obtained by a questionnaire containing questions about demographic characteristics of doctors and their knowledge about CPR. Questionnaires were applied between 27.02.2012 and 04.06.2012. The chi-square test was used for categorical variables. A value of p< 0.05 was considered statistically significant. Results: It was determined that 90% of the participants included in the study applied and/or observed CPR, and 62% of participants did not attend any CPR course. In addition, 64.1% of the doctors were found to be aware of guidelines prepared every 5 years. Although 65.2% of the doctors who attended a course previously gave a correct answer for the question about the number of cardiac compressions during adult CPR, 47.6% of the doctors who did not attend a course gave the correct answer (p= 0.014). Additionally, 71.9% of participants who attended a course previously and 51.7% of participants who did not replied correctly to the question 'What should be done immediately after defibrillation during CPR?' And also the results for the question about how many joules is necessary to begin defibrillation with a monophasic defibrillator were statistically significant according to the attendance for a CPR course (p< 0.005). Conclusion: In this study, we have identified the lack of knowledge of the doctors about resuscitation.Öğe Açık kalp cerrahisinde malnütrisyon oranları ve ilişkili risk faktörlerinin araştırılması(Turkish Anaesthesiology and Intensive Care Society, 2014) Bayır, Hakan; Tekelioğlu, Ümit Yaşar; Koçoğlu, Hasan; Akkaya, Akcan; Demirhan, Abdullah; Bilgi, Murat; Erdem, Kemalettin; Dağlar, Bahadır; Yıldız, İsaObjective: Rates of malnutrition in hospitalized patients may vary depending on the type of the hospital and patient population. Malnourished patients have higher mortality and morbidity rates, longer length of hospital stay (LOS) and much more drug use than patients without malnutrition. We aimed to investigate rates of malnutrition in hospitalized patients undergoing open heart surgery and the associated risk factors. Material and Methods: We studied 50 ASA II-III patients aged between 40-85 years undergoing elective open heart surgery. Patients whose NRS-2002 score ? 3 and/or, Body Mass Index (BMI) <18.5 kg/m2, and/or serum albumin level <3 g/dl were evaluated as malnourished. Preoperatively patients' demographic data, preoperatwe left ventricular ejection fraction (LVEF), pulmonary function test results (FVC, FEV1, FEV1/FVC), hemoglobin, hematocrit, lymphocyte count, albumin, CRP, and cholesterol values were recorded. LOS in intensive care unit and service, type of complications that occurred during hospitalization were recorded. Pulmonary function test results were also obtained on the day patients discharged. Results: Malnutrition rate was 20 % in patients with open-heart surgery. Patients at risk of malnutrition had longer postoperative intubated time, LOS in ICU and in service, higher rates of postoperative complications and louer preoperative and postoperative FEV1, FVC, and FEV1/FVC values than those without risk of malnutrition. But these findings were not statistically significant. In addition, LOS in the ICU and service were found to be relatively longer in overweight and obese patients. Conclusion: In summary, a high rate of malnutrition can be observed in patients with open-heart surgery. Malnutrition has negative postoperative effects in these patients.Öğe Ameliyathane ve servis çalışanlarında hepatit B, hepatit C ve HIV seroprevlalansının karşılaştırılması(2012) Tekelioğlu, Ümit Yaşar; Koçoğlu, Mücahide Esra; Akkaya, Akcan; Demirhan, Abdullah; Hakyemez, İsmail Necati; Taş, Tekin; Bayır, HakanAmaç: Ameliyathane ve servislerde çalışan hekimler, yardımcı sağlık personelleri (anestezi teknisyenleri ve hemşireler) ve temizlik personelleri sıklıkla kan ve vücut sıvıları ile temas edebilmektedir. Bu sıvılar ve kontamine aletler Hepatit B, Hepatit C veya HIV virüs enfeksiyonu bulaşmasına neden olabilecek önemli sebeplerdendir. Bu çalışmanın amacı Abant ‹zzet Baysal Üniversitesi Tıp Fakültesi Ameliyathane’sinde ve dahili servislerinde çalışan personelin Hepatit B virüsü (HBV), Hepatit C virüsü (HCV) ve Kazanılmış ‹mmün Yetmezlik virus (HIV) seroprevalansını ve immünizasyon durumunu saptamaktır. Ayrıca aşılanma ve alınabilecek tedbirlerin güncel literatür eşliğinde tartışılması hedeşenmiştir. Yöntem: Ameliyathane ve servis ortamında çalışmaya katılan toplam 122 kişinin bilgilendirilmiş onam formları alındıktan sonra, kan örnekleri toplandı. Katılımcılar sunulan anket formunu doldurarak, demografik bilgilerini, klinikte çalışma sürelerini, hepatit enfeksiyon hikâyesini ve immünizasyon durumlarını bildirdiler. Hepatit B yüzey antijeni, yüzey antikoru (anti-HBs), çekirdek antikoru (anti-HBc), anti-HCV ve anti-HIV durumu "enzyme linked immunosorbent assay" metodu kullanılarak araştırıldı. Verilerin istatistiksel incelemesinde "Ki- kare testi" ve "Ki- kare kökenli Phi-Cromer’s V, Contingency Coefficient, Goodman and Kruskal tau ve Uncertainly Coefficient testi" kullanıldı. p< 0,05 istatistiksel olarak anlamlı kabul edildi. Bulgular: Çalışmaya 43 kadın %35,2 ve 79 erkek %64,8 toplam 122 gönüllü katıldı. Gönüllülerin 62’ si ameliyathane çalışanı, 60’ ı servis çalışanı idi. 30’ u doktor (%24,6), 60’ ı yardımcı sağlık personeli (hemşire ve anestezi teknisyeni) (%49,2) ve 32’ si yardımcı personel (%26,2) idi. 108 katılımcı (%88,5) 5 yıldan az, 12 katılımcı (%9.8) 10 yıldan az, 2 katılımcı da (%1,6) 10 yıldan fazla çalışmıştı. Servis ve ameliyathane çalışanlarında, hepatit belirteçlerinde istatistiksel açıdan fark olmadığı görüldü. Hepatit hikayesi olmayan ameliyathane çalışanlarından, 6’sında (%5), servis çalışanlarından ise 2’sinde (%1,6) anti-HBc’ nin (+) olduğu saptandı. Ameliyathane çalışanlarının 52’sinde (%42,6), servis çalışanlarının ise 50’sinde (%40,9) anti-HBs (+) bulundu. Katılımcıların tümünde anti-HCV ve anti-HIV negatifti. Sonuç: Bu çalışma rutin aralıklarla yapılan labaratuvar tetkiklerin ve hastane ortamında alınan standart önlem ve tedbirlerin, risk altında bulunan sağlık çalışanlarında önemini bir kez daha ortaya koymuştur.Öğe Antiemetic effects of dexamethasone and ondansetron combination during cesarean sections under spinal anaesthesia(Makerere Univ, Fac Med, 2013) Demirhan, Abdullah; Tekelioğlu, Yaşar Ümit; Akkaya, Akcan; Özlü, Tülay; Yıldız, İsa; Bayır, Hakan; Koçoğlu, Hasan; Duran, BülentBackground: Nausea and vomiting are frequently seen in patients undergoing cesarean section (CS) under regional anesthesia. We aimed to compare the antiemetic efficacy of ondansetron and dexamethasone combination with that of the use of each agent alone to decrease the incidence of post-delivery intraoperative nausea and vomiting (IONV) during CS under spinal anesthesia. Objective: To compare the antiemetic efficacy of ondansetron and dexamethasone combination with that of the single use of each agent to decrease the incidence of postdelivery IONV during CS under spinal anesthesia. Methods: A randomized, prospective, double blind study was performed on 90 patients undergoing planned CS under spinal anesthesia. Patients received 4mg ondansetron in Group O, 8mg dexamethasone in GroupD, 4mg ondansetron+8mg dexamethasone in Group OD intravenously within 1-2 minutes after the umbilical cord was clamped. Frequency of postdelivery IONV episodes was recorded. Results: A total of 86 eligible patients were included in the study. There were 29 patients in Group O, 29 patients in Group D and 28 patients in Group OD. There were no statistically significant difference between the groups in terms of baseline characteristics and intraoperative managements. Frequency of intraoperative nausea, retching and vomiting experiences were similar between the groups(p>0.05). Conclusion: Single dose 4mg ondansetron, 8mg dexamethasone, or combined use of 8mg dexamethasone+4mg ondansetron, given intravenously is all effective agents for the control of postdelivery IONV. Combined use of dexamethasone and ondansetron for the same indication does not seem to increase the antiemetic efficacy.Öğe Assessment of intracranial pressure with ultrasonographic measurement of optic nerve sheath diameter on patients undergoing suspension direct laryngoscopy(Springer, 2023) Karalı, Elif; Demirhan, Abdullah; Güneş, Akif; Yıldız, İsa; Ural, AhmetPurpose The study aims to examine the effect on intracranial pressure by calculating the optic nerve sheath diameter (ONSD) using ultrasound in patients who underwent suspension direct laryngoscopy. Methods Thirty-three patients who underwent suspension direct laryngoscopy were included in this prospective observational study. ONSD measurement was performed using a high-frequency linear probe. The ONSD basal (T0) value was determined using ultrasound in the supine position before the induction. Ultrasonography was used to record ONSD in the Boyce Jackson position (T1) just before inserting the laryngeal blade, in the Boyce Jackson position just before removing the laryngeal blade (T2), and in the supine position (T3) just before extubation. Results A statistically significant rise (p < 0.001) was seen between the patients' baseline ONSD values and the values at T1, T2, and T3. The optic nerve sheat diameter level recorded prior to withdrawing the laryngeal blade (T2) was considerably greater than the ONSD level calculated instantly before insertion of the laryngeal blade (T1) (p < 0.001). The ONSD value prior to extubation (T3) following the removal of the laryngeal blade was considerably smaller than the ONSD value prior removing the laryngeal blade (T2) (p < 0.001). Conclusions This study found that when the laryngeal blade is mounted during the suspension direct laryngoscopy surgery, there is a significant increase in ultrasonographically measured ONSD and increased the ONSD even further during the time the mouth gag was remained in situ. This is the first research to indicate that measuring ONSD with ultrasonography during suspension direct laryngoscopy raises intracranial pressure.Öğe Association between hemogram parameters and survival of critically Ill patients(Sage Publications Inc, 2019) Karagöz, İbrahim; Aktaş, Gülali; Yoldaş, Hamit; Yıldız, İsa; Ögün, Muhammed Nur; Bilgi, Murat; Demirhan, AbdullahAim: Recently, hemogram parameters, such as mean platelet volume (MPV), had been proposed as novel inflammatory and prognostic factors. In present retrospective analysis, we aimed to determine and compare MPV of survived and dead patients whom admitted to intensive care unit (ICU) of our institution. Methods: We recorded hemogram parameters and other laboratory data and demographic characteristics of patients treated in ICU. Patients are divided into 2 groups-dead patients and survived patients. Laboratory data of survived patients compared to those of dead patients. Results: Age, gender, and other laboratory variables were not significantly different between dead and survived patients. On the other hand, MPV of survived patients was significantly higher than that of the dead patients (P = .001). Conclusion: We think that elevated MPV levels in an ICU patient should alert clinicians for worse outcome. Physicians should be more careful in the management of these patients.Öğe At open heart surgery; is the side graft axillary artery canulation technique safe?(2013) Erdem, Kemalettin; Buğra, Onursal; Bozoğlan, Orhan; Dağıstan, Emine; Tekelioğlu, Ümit; Demirhan, Abdullah; Dağlar, BahadırAmaç: Çalışmadaki amacımız, çıkan aorta ve arkus aortayı (proksimal aorta) içine alan patolojilerinde yan greft tekniği ile yapılan sağ aksiller arter kanülasyonun (AAK) postoperatif erken dönem mortalite, morbidite sonuçları ve sağ AAK yerinde gelişen orta-geç dönem komplikasyonların araştırılmasıdır. Gereç ve Yöntemler: Kliniğimizde yan greft tekniği-sağ AAK ile proksimal aortaya müdahele edilen 45 hasta çalışmaya dâhil edildi. Hastaların postoperatif erken dönem mortalite, morbidite, aksiller arter, aksiller ven, brakial pleksus yaralanması retrospektif olarak araştırıldı. Toplam 32 hastanın sağ AAK bölgesindeki değişiklikler Doppler ultrasonografi ile incelendi. Bulgular: Hastaların, yaş ortalaması 59,25±13,7, 34’ü (%75,5) erkek idi. Erken dönem mortalite 7 (%15,55), geçici nörolojik disfonksiyon 2 (%4,44), erken inme 1 (%2,22), ortalama yoğun bakımda kalma süresi 3,35±1,61 gün, hastanede kalış süresi 13,44±4,5 gün olarak tespit edildi. Ortalama 24±18,5 (1-52) aylık orta dönem takiplerde, hastaların hiç birinde sağ AAK yerinde stenoza rastlanmazken, 4 (%16,66) hastada sağ AAK yerinde en büyüğü 4,6 mm, en küçüğü 1,4 mm olan sakküler anevrizma tespit edildi. Sonuç: Proksimal aorta patolojilerinde yan greft tekniği ile sağ AAK düşük morbidite ve mortalitesi nedeni ile güvenlidir. Dekanülasyon sonrası yan greftin kapatılması sırasında aksiller arterde anevrizmatik kese bırakılmamasına dikkat edilmelidir.Öğe At open heart surgery; Is the side graft axillary artery canulation technique safe?(2013) Erdem, Kemalettin; Bu?ra, Onursal; Bozo?lan, Orhan; Da?istan, Emine; Tekelio?lu, Ümit; Demirhan, Abdullah; Da?lar, BahadirObjective: To investigate both postoperative early-mid term mortality and morbidity results of right axillary artery cannulation (AAC) that is done with the side graft technique in the pathologies including ascending aorta, aortic arch (proximal aorta) and late term complications occuring in the place of AAC. Material and Methods: Forty-five patients whose proximal aorta was intervened by using side graft-right AAC. Injury of axillary vein and brachial plexus and early postoperative mortality and morbidity were retrospectively investigated via patient file. The changes in the place of right AAC were analyzed with Doppler ultrasonography after calling tha patients whose addresses were available. Results: We recruited 45 patients (34 males and 11 females; age, 59.2±13.7years) who underwent aortic surgery. Early postoperative mortality was 7 (15.55%), transient neurologic disfunction was 2 (4.44%), early stroke was 1 (2.22%), the average length of intensive care unit was 3.35±1.61 days, length of discharge was 13.44±4.5 days. While stenosis was not encountered in the place of right AAC in none of the patients at the averagely 24±18.5 (1-52) monthly follow-up, saccular enlargement of which the smallest was 1.4 mm and the biggest was 4.6 mm in the place of right AAC was detected in 4 (16.66%) patients. Conclusion: Right AAC with side graft technique in proximal aorta pathologies is safe because of low morbidity and mortality. Not to create aneurysmal sac in axillary artery while closing the side graft after decanulation is a remarkable matter. © 2013 by Erciyes University School of Medicine.Öğe Atropa Belladonna (Güzel Avrat Otu) meyvesi ile ilişkili antikolinerjik toksik sendrom: Bir olgu sunumu(2013) Demirhan, Abdullah; Tekelioğlu, Ümit Yaşar; Yıldız, İsa; Korkmaz, Tanzer; Bilgi, Murat; Akkaya, Akcan; Koçakoğlu, HasanAtropa Belladonna (güzel avrat otu) ile gelişen zehirlenmeler antikolinerjik sendroma yol açabilmektedir. Bitkinin yüksek miktarda alınması letarji, koma ve hatta ölümle sonuçlanabilen ciddi klinik tabloya neden olabiir. Bu olgu sunumunda ülkemizde güzel avrat otu olarak bilinen bitkinin meyvesinin bol miktarda yenmesi sonucu gelişen ciddi antikolinerjik sendromu literatür eşliğinde paylaşmayı amaçladık.Öğe Atropa bellodonna fruit (Deadly Nightshade) related anticholinergic toxic syndrome: A case report(2013) Demirhan, Abdullah; Tekelio?lu, Ümit Yaşar; Yildiz, Isa; Korkmaz, Tanzer; Bilgi, Murat; Akkaya, Akcan; Koço?lu, HasanAtropa Belladonna related poisoning may lead to anticholinergic syndrome. Ingestion of high amounts of the plant may cause lethargy, coma, and even a serious clinical picture that could lead to death. In this case report, we aim to share a case of anticholinergic syndrome that developed after ingestion of the fruit called "Deadly Nightshade" in our country. © 2013 by Turkish Anaesthesiology and Intensive Care Society.Öğe Awake fibre-optic intubation in a patient with cervico-occipital fixator(2013) Akkaya, Akcan; Yildiz, Isa; Demirhan, Abdullah; Tekelio?lu, Ümit Yaşar; Koço?lu, HasanA 23-year-old male patient with cervico-occipital fixator was scheduled for surgery due to injuries to the right forearm. The patient's thyromental distance was 5 cm, mouth opening grade II, sternomental distance 10 cm and Mallampati score 4. The loss of extension of the neck in particular indicated difficult intubation. Anaesthetic procedures are almost always difficult in patients with cervico-occipital fixators; the limited cervical extension complicates both intubation and ventilation. In this report, application of general anaesthesia using awake fibre-optic bronchoscopic intubation (FOB) is described. After routine monitoring of vital signs and premedication, hypopharyngeal topical anaesthesia was applied with 10% lidocaine sprayed twice via the appropriate nostril. Superior laryngeal nerve block was performed with local anaesthetic infiltration of tissues 1 cm below the hyoid bone. Lingual and pharyngeal branches of the glossopharyngeal nerve were blocked. Transtracheal block was performed. Following completion of local anaesthesia, the patient, who was oxygenated with 5 L min-1 of 100% O2, was intubated using the awake FOB technique. After muscle relaxation, the patient underwent a microsurgical operation to repair eight tendons, one artery, and one nerve. Surgery lasted for 5 hours. When the extubation criteria were met, the patient was extubated. In cases of cervico-occipital fixation, which causes severe limitation of neck movements, the use of awake fibre-optic intubation should be considered. © 2013 by Turkish Anaesthesiology and Intensive Care Societ.Öğe Bilateral orofasiyal yarıklı bir infantın anestezi yönetimi (Tessier Tip 3): Olgu sunumu(2014) Demirhan, Abdullah; Akkaya, Akcan; Tekelioğlu, Ümit Yaşar; Karabekmez, Furkan Erol; Bilgi, Murat; Yıldız, İsa; Koçoğlu, HasanTessier yüz yarıkları çok nadir görülmekte olup konjenital olarak birçok anomaliyi de içinde barındırmaktadır. Özelikle Tessier tip 3 de bulunan oblik yüz yarığı, yarık dudak ve damak bu hastaların havayolu yönetimini oldukça güçleştirmektedir. Uygulanacak olan anestezisi için multidisipliner bir yaklaşım gerekmektedir. Bu olguda Tessier tip 3 yüz yarıklı bir hastanın anestezi uygulaması ve anestezi yönetimi tartışılmıştır.Öğe A case of anesthesia mumps after general anesthesia(Springer Tokyo, 2012) Tekelioğlu, Ümit Yaşar; Akkaya, Akcan; Apuhan, Tayfun; Demirhan, Abdullah; Bayır, Hakan; Koçoğlu, HasanÖğe Colostomy with transversus abdominis plane block(Aves, 2015) Tekelioğlu, Ümit Yaşar; Demirhan, Abdullah; Şit, Mustafa; Kurt, Adem Deniz; Bilgi, Murat; Koçoğlu, HasanTransversus abdominis plane (TAP) block is one of the abdominal field block. The TAP block is used for both anaesthetic management and post-operative pain therapy in lower abdominal surgery. TAP block is a procedure in which local anaesthetic agents are applied to the anatomic neurofacial space between the internal oblique and the transversus abdominis muscle. TAP block is a good method for post-operative pain control as well as allows for short operations involving the abdominal area. In this article, a case of colostomy under TAP block is presented.Öğe Comparison of effects of low and high flow desflurane anaesthesia on hemogram parameters(2019) Yoldaş, Hamit; Karagoz, İbrahim; Ekici, Mustafa Ayhan; Eş, Abdulhamit; Yıldız, İsa; Demirhan, Abdullah; Bilgi, MuratObjectives: To compare the effects of low and high flow desflurane anaesthesia on hemogram parameters in lower abdominal surgeries. Methods: Sixty female patients who underwent lower abdominal surgery under general anaesthetic were included in this prospective study. Patients were randomly divided into two groups, as Group I (low flow) and Group II (high flow), and then compared with each other according to their demographic features and hemogram parameters. Results: Groups were statistically similar, and there were no significant differences in terms of demographic data between the groups (p>0.05). The comparisons of hemogram parameters within the groups showed that there were significant differences in plateletcrit, platelet-lymphocyte ratio and neutrophil-lymphocyte ratio values in Group I (p<0.05). The comparisons of hemogram parameters within Group II showed a statistically significance in plateletcrit and platelet-lymphocyte ratio values. A statistically significant difference was found for red cell distribution width, neutrophil- lymphocyte ratio, platelet-lymphocyte ratio and plateletcrit values between groups for the pre-operative and post-operative values of hemogram parameters (p<0.05). Conclusion: Our study showed that the administration of low flow anaesthesia led to a positive effect on the inflammatory response by lowering neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and red cell distribution width values, in comparison to high flow anaesthesia.Öğe The comparison of hepatitis B, hepatitis C and HIV seroprevalence in operating room and clinical staff(2012) Tekelio?lu, Ümit Yaşar; Koço?lu, Esra; Akkaya, Akcan; Demirhan, Abdullah; Hakyemez, Ismail; Taş, Tekin; Bayir, HakanObjective: Physicians, allied health staff (anaesthesia technicians and nurses) and medical ward staff in operating rooms and in the clinics may often contact with blood or body fluids. These fluids and contaminated instruments are important causes of infection transmission including hepatitis B, hepatitis C or HIV. The objective of this study was to determine the immunization status and seroprevelance of Abant Izzet Baysal University Medical School Hospital operation room personnel and medical ward staff for Hepatitis B virus (HBV), Hepatitis C virus (HCV) and human immunodeficiency virus (HIV). In addition to this, we aimed to discuss vaccination and measures that can be taken with the aid of current literature. Method: After obtaining informed consent from 122 operating room personnel and service staff, blood samples were collected. A self-assessment questionnaire was used to obtain the informations including demographic information, duration of clinical practice, previously diagnosed hepatitis infection and the immunization status. Serum samples were tested for hepatitis B surface antigen, surface antibody (anti-HBs), core antibody, anti-HCV, and anti-HIV using the enzyme linked immunosorbent assay method. For statistical analysis, Chi-square tests and Phi- Cramer's V, Contingency Coefficient, Goodman and Kruskal tau and Uncertainly Coefficient tests were used. P values <0.05 were considered statistically significant. Results: 43 women (35.2%) and 79 men (64.8%) participated in a total of 122 volunteers in this study. Sixty-two volunteers were operating room personnel and sixty participants were medical ward staff. A total of 30 (24.6%) physicians, 60 (49.2%) allied health staff (anaesthesia technicians and nurses) and 32 (26.2%) medical ward staff were included in the study. One hundred and eight participants have been working less than 5 years (88.5%), 12 participants have been working less than 10 years (9.8%) and 2 participants have been working more than 10 years (1.6%). Hepatitis markers of operating room personnel and medical ward staff were not statistically different. Eight of 120 participants without a history of hepatitis, had positive anti-HBc (6.6%). All were negative for anti-HCV and anti-HIV. Conclusion: This study shows once again that the importance of laboratory examinations made by routine intervals and standard precautions taken in the hospital for health care workers at risk.Öğe Comparison of the effects of bispectral index-controlled use of remifentanil on propofol consumption and patient comfort in patients undergoing colonoscopy(Univ Catholique Louvain-Ucl, 2015) Bilgi, Murat; Tekelioğlu, Ümit Yaşar; Şit, Mustafa; Demirhan, Abdullah; Akkaya, Akcan; Yıldız, İsa; Koçoğlu, HasanBackground and study aims : In endoscopic procedures, propofol can be safely administered either alone or in conjunction with remifentanil. The aim of the study is to compare the effects of the administration of propofol alone and the administration of remifentanil in addition to propofol on patient and endoscopist satisfaction, preoperative hemodynamic response, and propofol consumption. Materials and methods : A totally 60 patients were enrolled in the study. Propofol group (Group 1) : A 0.4-mg/kg propofol bolus and 1 mg/kg/h maintenance infusion of propofol until a bispectral Index-value of 70-75 was achieved. Propofol + remifentanil group (Group 2) received a 0.4 mg/kg propofol bolus dose and maintained with a 0.5 mg/kg/h infusion of propofol + 0.2 mcg/kg/min infusion of remifentanil. The infusion dose of remifentanil was maintained, and the propofol infusion dose was titrated until a BIS value of 7075 was achieved. Results : In Group 1 (colonoscopic intervention 1 and 5 min) and Group 2 (colonoscopic intervention 10 min.), main blood pressure (MBP) value has a significant decrease. Hypotension occurred in 6 patients in group 1, while 12 patients in group 2. No significant difference was found between the Patient's endoscopist' satisfaction, MBP and heart rate. Propofol consumption was greater in group 1 than in group 2. When the Ramsay sedation levels of Group 1 and Group 2 were compared, a statistically significant difference was observed. Conclusion : The addition of remifentanil to propofol may be an alternative to the use of alone propofol for sedation in colonoscopic interventions.Öğe A comparison of the effects of lidocaine or magnesium sulfate on hemodynamic response and QT dispersion related with intubation in patients with hypertension(ARSMB-KVBMG, 2014) Kıracı, Gökhan; Demirhan, Abdullah; Tekelioğlu, Ümit Yaşar; Akkaya, Akcan; Bilgi, Murat; Erdem, Alim; Bayır, Hakan; Koçoğlu, Hasan; Yıldız, İsaBackground: The aim of this study was to investigate the effect of magnesium administered before induction on the hemodynamic response and QT dispersion (QTd) related with intubation in hypertensive patients and to compare it with lidocaine.Methods: Patients with essential hypertension who were under ? 65 years old, scheduled for elective surgery with a Mallampati score of I-II were included in the study. Patients were randomly divided into three groups; group M (n=20) received magnesium sulfate, group L was prescribed lidocaine, and group C (control group) received saline. Standard 12-lead ECG readings were taken before the induction of anesthesia and at the first and fifth minutes following intubation.Results: There were no statistically significant differences between the groups in terms of age, sex and demographic characteristics. There was no significant difference in the QT interval values before induction and 5 minutes after intubation in all groups. In group M, QTd values were significantly lower at the first and fifth minutes than before induction. There were no statistically significant differences in QTd values at different times in group L and group C.Conclusion: QTd is not increased during tracheal intubation in hypertensive patients so there is no need for magnesium sulfate for these patients. But as QTd has been shown to increase during tracheal intubation for coronary artery disease patients, magnesium sulfate might be useful for those patients although future studies are required to confirm this statement.Öğe Comparison of the effects of magnesium sulphate and dexmedetomidine on surgical vision quality in endoscopic sinus surgery : randomized clinical study(Elsevier Science Inc, 2014) Akkaya, Akcan; Tekelioğlu, Ümit Yaşar; Demirhan, Abdullah; Bilgi, Murat; Yıldız, İsa; Apuhan, Tayfun; Koçoğlu, HasanBackground and objectives: Even a small amount of bleeding during endoscopic sinus surgery can corrupt the endoscopic field and complicate the procedure. Various techniques, including induced hypotension, can minimize bleeding during endoscopic sinus surgery. The aim of this study was to compare the surgical vision quality, haemodynamic parameters, postoperative pain, and other effects of magnesium, a hypotensive agent, with that of dexmedetomidine, which was initially developed for short-term sedation in the intensive care unit but also is an alpha 2 agonist sedative. Method: 60 patients between the ages of 18 and 45 years were divided into either the magnesium group (Group M) or the dexmedetomidine group (Group D). In Group M, magnesium sulphate was given at a pre-induction loading dose of 50 mg kg(-1) over 10 min and maintained at 15 mg kg(-1) h(-1); in Group D, dexmedetomidine was given at 1 mcg kg(-1) 10 min before induction and maintained at 0.6 mcg kg(-1) h(-1). Intraoperatively, the haemodynamic and respiratory parameters and 6-point intraoperative surgical field evaluation scale were recorded. During the postoperative period, an 11-point numerical pain scale, the Ramsay sedation scale, the nausea/vomiting scale, the adverse effects profile, and itching parameters were noted. Results: Group D showed a significant decrease in intraoperative surgical field evaluation scale scale score and heart rate. The average operation time was 50 min, and Group M had a higher number of prolonged surgeries. No significant difference was found in the other parameters. Conclusions: Due to its reduction of bleeding and heart rate in endoscopic sinus surgery and its positive impacts on the duration of surgery, we consider dexmedetomidine to be a good alternative to magnesium. (C) 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.Öğe Comparison of topical tramadol and ketamine in pain treatment after tonsillectomy(Wiley, 2013) Tekelioğlu, Ümit Yaşar; Apuhan, Tayfun; Akkaya, Akcan; Demirhan, Abdullah; Yıldız, İsa; Şimşek, Tuğçe; Gök, Üzeyir; Koçoğlu, HasanObjectives/Aim The primary objective of this study is to evaluate the effects of topically applied ketamine or tramadol on early postoperative pain scores in children undergoing tonsillectomy. The secondary aim of the study is to assess nausea, vomiting, difficulty in swallowing, and sore throat characteristics of the patients. Background Tonsillectomy surgery is frequently associated with postoperative pain, which usually requires substantial consumption of analgesics including opioids. Safe and effective post-tonsillectomy pain control is still a clinical dilemma, in spite of the use of various surgical and anesthetic techniques. Methods A total of 60 children, aged between 4 and 10years, scheduled for tonsillectomy, were randomly assigned to one of three groups. Study drugs were administered to both tonsillar fossae for 5min. In 5ml artificial saliva, Group K (n=20) received 0.4ml (20mg) ketamine and Group T (n=20) received 0.8ml tramadol HCl solution. Group C (n=20) received only 5ml saline as a control. Ramsay Sedation Scale and FACES PRS Score, nausea, vomiting, difficulty in swallowing, and sore throat were evaluated. Results There was no difference among the groups in terms of baseline characteristics, including age, sex, and ASA profile (0.05 for all). Systolic blood pressure, diastolic blood pressure, mean blood pressure, heart rate, respiratory rate, and saturation of peripheral oxygen (SpO2) values were not significantly different among the groups in all time points (0.05 for all). There was a statistically significant difference among the groups according to Ramsay Sedation Scales in 40th minute (P<0.001). There were statistically significant differences among the groups in terms of Wong-Baker FACES Pain Rating Scale Score in all time points (P<0.004 for all). There was a statistically significant difference among the groups in terms of rescue analgesia necessity in 5th and 10th minute (P<0.001 and P=0.003). There was a statistically significant difference among the groups in terms of sore throat in 5th and 10th minute (P<0.001 for both). Neither rescue analgesia necessity nor sore throat characteristics was different between the Group T and Group K in all time points. Conclusion Topical tramadol and ketamine seem to be safe, effective, and easy analgesic approach for decreasing tonsillectomy pain.
