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Öğe 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, 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 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, IsmailObjective: 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.Öğe Evaluation of the efficacy of rectalmisoprostol versus intravenous oxytocin for the prevention of postpartumhemorrhage(Galenos Yayincilik, 2006) Gul, Ozlem Kemik; Somunkiran, Asli; Ozdemir, Ismail; Yucel, Oguz; Demirci, FuatObjective: To compare the effectiveness of rectally administered prostaglandine E1 anolog misoprostol and parenterally oxytocin for the prevention of postpartum hemorrhage. Design: Prospective randomized trial Setting: University hospital Patients: 240 full term pregnant women who were in active labor. Interventions: 80 patients in group 1 received 200 mu g misoprostol rectally, 80 patients in Group 2 received 400 mu g rectally misoprostol, and the third group received a solution of 1000 ml 5% DRL + 10 IU oxytocin, immediately after the delivery of the fetus. Main outcome measures: Postpartum blood loss and potential side effects of misoprostol were evaluated. Results: No statistically significant difference was found among the three groups regarding the average blood loss (F=1.50, p=0.22). Average duration of the third stage of labor was similar in all groups (F=1.13, p=0.32). Hematocrit values were similar in the groups both before (F=3.28, p=0.52) and after the delivery and (F=1.84, p=0.16). Conclusions: No differences were found between rectallymisoprostol and oxytocin treatment for the prevention of postpartum hemorrhage. Nevertheless, misoprostol can be preferred in the prevention of postpartum hemorrhage because it does not require special storage conditions, can be used safely in hypertensive patients, can be stored for many years, it is resistant to heat and its side effects such as nausea and vomiting are low when used rectally.