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    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, Ismail; Kocaman, Buket; Hayit, Feray; Demirci, Fuat
    Objective: 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.
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    Comparison of Costs and Efficacy of Intravenous and Orally Disintegrating Ondansetron Tablet as a Prophylactic Antiemetic Therapy in Major Gynecologic Operations
    (Galenos Yayincilik, 2005) Demiraran, Yavuz; Ozdemir, Ismail; Kocaman, Buket; Hayit, Feray; Demirci, Fuat
    Objective: 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.
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    A comparison of intrathecal sufentanil combined with either hyperbaric bupivacaine or hyperbaric ropivacaine for cesarean deliveries
    (2006) Hayit, Feray; Demiraran, Yavuz; Sezen, Gülbin; Kocaman, Buket; Iskender, Abdulkadir; Özdemir, Ismail
    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.
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    Emergency thoracic epidural anesthesia with ropivacaine for a cachectic geriatric patient with ileus
    (2006) Kocaman Akbay, Buket; Hayit, Feray; Ozaydin, Ismet; Zengin, Ahmet; Demirarani, Yavuz
    Objective: 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.
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    Evaluation of the effectiveness of fentanyl, tramadol and diclofenac in combination with propofol for dilation and curettage
    (Galenos Yayincilik, 2006) Demiraran, Yavuz; Somunkiran, Asli; Sezen, Gulbin; Kocaman, Buket; Hayit, Feray; Ozdemir, Ismail
    Objective: To compare the value of three agents in terms of providing postoperative analgesia in patients having dilation and curettages. Their effects on hemodynamic parameters were evaluated. Recovery and sedation properties were also assessed. Design: Prospective, randomized trial Setting: University hospital Patients: Sixty three patients who underwent fractional curettage. Interventions: Diclofenac 1 mg/kg intramuscularly 30 minutes before induction and tramadol 1 mg/kg intravenously 15 minutes before induction were given in group 1 and 2, respectively. The third group received fentanyl 1 mu g/kg intravenously for induction. Then, induction was provided with propofol 2 mg/kg and % 50 air and % 50 oxygen given with face mask. For anesthesia management 20% of the induction dose of propofol was used intermittently. Main outcome measures: Peroperative and postoperative haemodynamic parameters and SPO2 were recorded. Visual Analog Scale 0-10 cm, sedation score 0-4 point, Aldrete recovery scores 1-10 were assessed postoperatively at the 1, 5, 15, 30, and 120th minutes. Results: Peroperative and postoperative hemodynamic parameters showed no difference. The scores obtained by using Visual Analog Scale were also similar in all groups. There were no differences in sedation and Aldrete recovery scores in the three groups. On the other hand, propofol consumption was significantly lower in the fentanyl group when compared with the other two groups. Conclusion: Fentanyl usage decreased the amount of propofol when compared with diclofenac and tramadol administration. However, both tramadol and diclofenac were associated with lower amount of supplementary analgesic agents. They are both nonnarcotic analgesics. Therefore, preference of these two agents may be regarded more favorable.