Ethical Committee of Clinical Studies (decision number: 21.03). All procedures in this study invo... more Ethical Committee of Clinical Studies (decision number: 21.03). All procedures in this study involving human participants were performed in accordance with the 1964 Helsinki Declaration and its later amendments. Etik Kurul Onayı: Bu çalışma için onay Kırıkkale Üniversitesi Klinik Araştırmalar Etik Kurulu'ndan alınmıştır (karar no: 21.03). İnsan katılımcıların katıldığı çalışmalardaki tüm prosedürler, 1964 Helsinki Deklarasyonu ve daha sonra yapılan değişiklikler uyarınca gerçekleştirilmiştir.
Background Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variety... more Background Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variety of operations on the thorax, abdomen or pelvis. PVB is straightforward, e cacious in operations performed. This study was undertaken to evaluate how e cacious ultrasound-guided thoracic paravertebral block is when used in patients undergoing percutaneous nephrolithotomy (PCN). Methods A total of forty-four patients, falling in categories I to III of the American Society of Anesthesiologists, and aged between 18 and 65 years, who were scheduled for PCN, were randomly distributed into two groups. The anaesthetic intervention group (PVB) contained 22 individuals, who were injected at level T8-T9 with 20 mL 0.25% bupivacaine as a single administration. In the control group C, also containing 22 individuals, the intervention was not carried out. The groups were compared after PCN in terms of opioid use, pain score, opioid adverse effects pro le and the need for supplemental analgesia. Results Visual analogue scale pain scores whilst at rest or moving were lower at the level of statistical signi cance in the PVB group compared to controls at 2 and 4 hours post-surgery. At 6 and 8 hours postsurgery, the control group had a lower VAS score when moving, and this result reached statistical signi cance (p < 0.05). The controls used more opioid relief than the PVB group and had lower scores for satisfaction (p < 0.05). Conclusion Ultrasound-guided PVB using bupivacaine and an in-plane technique provides effective analgesia in PNL. It is associated with high scores on patient satisfaction and minimal complications.
Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, Jan 5, 2016
Marfan Sendromu (MS) 1/5000 oranında otozomal dominant geçiş gösteren bir bağ doku hastalığıdır. ... more Marfan Sendromu (MS) 1/5000 oranında otozomal dominant geçiş gösteren bir bağ doku hastalığıdır. Fibrillin-1 (FBN1) geninin 15q21 kromozomunda mutasyon vardır. İskelet sistemi anormallikleri, lens dislokasyonu, dural ektazi ve aort dilatasyonu ile karakterizedir. Hastaların %80'ninde kardiyovasküler sistemde birtakım değişiklikler mevcut olup bunlar; aort dilatasyonu, aort yetmezliği, mitral-triküspit valv prolapsusu ve regürjitasyonudur. Majör ölüm nedenleri arasında aortik anevrizma rüptürü ve diseksiyonu yer alır. Gebelikteki fizyolojik değişiklikler aort diseksiyonu patogenezi ve progresyonuna katkıda bulunmaktadır. Gebelikte artmış aort kompliyansı ve bunun sonucunda aort dilatasyonu sözkonusudur. Gebelik ve doğum MS'lu hastalarda yaşamı tehdit eden diseksiyonlara yol açar; özellikle de aort çapı 40 mm' den geniş ise. MS'lu gebelerde lumbal spinal deformiteler ve yaygın artrodezisler, epidural ve spinal anestezi başarısızlığını artırır. Benzer şekilde dural ektaziler dural delinme riskinin artmasına neden olur. Bu olgu sunumuyla MS'lu gebe kadında elektif sezaryen operasyonunda genel anestezi uygulamamızı sunmayı amaçladık.
Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, Jan 5, 2016
Nörofibromatozis Tip 1 (NF-1) ektodermal ve mezodermal dokulardaki yaygın etkileri nedeniyle otoz... more Nörofibromatozis Tip 1 (NF-1) ektodermal ve mezodermal dokulardaki yaygın etkileri nedeniyle otozomal dominant geçiş gösteren kalıtsal bir hastalık grubudur. Periferik sinirlerde multipl nörofibromlar ile karakterize olan hastalıkta kutanöz pigmente lekeler (cafe au lait spots) mevcuttur. Bu nörofibromlar sadece sinir sisteminde değil, orofarinks ve larinkste de bulunarak laringoskopiyi ve endotrakeal entübasyonu zorlaştırabilir. Bu olgu sunumuyla NF-1 tanılı gebe kadında elektif sezaryen operasyonunda spinal anestezi uygulamamızı sunmayı amaçladık.
Background and Aims Breast cancer and subsequent breast surgery is prevalent in North America. Ge... more Background and Aims Breast cancer and subsequent breast surgery is prevalent in North America. General anesthesia (GA) is
Background: Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variet... more Background: Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variety of operations on the thorax, abdomen or pelvis. PVB is straightforward, efficacious in operations performed. This study was undertaken to evaluate how efficacious ultrasound-guided thoracic paravertebral block is when used in patients undergoing percutaneous nephrolithotomy (PCN). Methods: A total of 44 patients, falling in categories I to III of the American Society of Anesthesiologists, and aged between 18 and 65 years, who were scheduled for PCN, were randomly distributed into two groups. The anaesthetic intervention group (PVB) contained 22 individuals, who were injected at level T8-T9 with 20 mL 0.25% bupivacaine as a single administration. In the control group C, also containing 22 individuals, the intervention was not carried out. The groups were compared after PCN in terms of opioid use, pain score, opioid adverse effects profile and the need for supplemental analgesia. Results: Visual analogue scale pain scores whilst at rest or moving were lower at the level of statistical significance in the PVB group compared to controls at 2 and 4 h post-surgery. At 6 and 8 h post-surgery, the control group had a lower VAS score when moving, and this result reached statistical significance (p < 0.05). The controls used more opioid relief than the PVB group and had lower scores for satisfaction (p < 0.05). Conclusion: Ultrasound-guided PVB using bupivacaine and an in-plane technique provides effective analgesia in PNL. It is associated with high scores on patient satisfaction and minimal complications. Trial registration: ClinicalTrials.gov, NCT04406012. Registered retrospectively, on 27 May 2020.
Background Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variety... more Background Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variety of operations on the thorax, abdomen or pelvis. PVB is straightforward, e cacious in operations performed. This study was undertaken to evaluate how e cacious ultrasound-guided thoracic paravertebral block is when used in patients undergoing percutaneous nephrolithotomy (PCN). Methods A total of forty-four patients, falling in categories I to III of the American Society of Anesthesiologists, and aged between 18 and 65 years, who were scheduled for PCN, were randomly distributed into two groups. The anaesthetic intervention group (PVB) contained 22 individuals, who were injected at level T8-T9 with 20 mL 0.25% bupivacaine as a single administration. In the control group C, also containing 22 individuals, the intervention was not carried out. The groups were compared after PCN in terms of opioid use, pain score, opioid adverse effects pro le and the need for supplemental analgesia. Results Visual analogue scale pain scores whilst at rest or moving were lower at the level of statistical signi cance in the PVB group compared to controls at 2 and 4 hours post-surgery. At 6 and 8 hours postsurgery, the control group had a lower VAS score when moving, and this result reached statistical signi cance (p < 0.05). The controls used more opioid relief than the PVB group and had lower scores for satisfaction (p < 0.05). Conclusion Ultrasound-guided PVB using bupivacaine and an in-plane technique provides effective analgesia in PNL. It is associated with high scores on patient satisfaction and minimal complications.
Archives of Clinical and Experimental Surgery, 2016
The intra-abdominal pressure (IAP) exceeding 12 mmHg is called intra-abdominal hypertension (IAH)... more The intra-abdominal pressure (IAP) exceeding 12 mmHg is called intra-abdominal hypertension (IAH) which has deleterious pathophysiological consequences [1,2]. IAH can be encountered in many clinical conditions, such as trauma, retro-/intra-abdominal bleeding, pancreatitis, aggressive fluid resuscitation, intestinal obstruction, tumors and pneumoperitoneum for laparoscopy [1,2]. As it has respiratory, renal, splanchnic, and cerebral complications, much effort has gone in to diagnosis and managing IAH in the last decade. Besides well-known management principles consisting of serial monitoring of IAP, optimization of systemic perfusion and urgent surgical decompression,
Introduction: Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are pot... more Introduction: Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are potentially life-threatening conditions in critically ill patients. Laparascopic surgery is the gold standard and has been widely performed for many procedures since its inception in the early 1980s. Pneumoperitoneum is essential for laparascopic surgery. Dexmedetomidine is a potent and highly selective α-2 adrenoceptor agonist with sympatholytic, sedative, amnestic and analgesic properties without respiratory depression. There is increasing evidence of its organ protective effects against ischemic and hypoxic injury, including neuroprotection, cardioprotection and renoprotection. The aim of this experimental study was to investigate the effects of the α-2 adrenoceptor agonist, dexmedetomidine on IAH induced by renal injury. Materials and methods: A total of 24 male Wistar-albino rats were randomly separated into 4 groups as the control group (CG, n=6), sham group (SG, n=6), low-dose group ...
Pressure-controlled ventilation (PCV) is less frequently employed in general anesthesia. With its... more Pressure-controlled ventilation (PCV) is less frequently employed in general anesthesia. With its high and decelerating inspiratory flow, PCV has faster tidal volume delivery and different gas distribution. The same tidal volume setting, delivered by PCV versus volume-controlled ventilation (VCV), will result in a lower peak airway pressure and reduced risk of barotrauma. We hypothesized that PCV instead of VCV during laparoscopic surgery could achieve lower airway pressures and reduce the systemic stress response. Forty ASA I-II patients were randomly selected to receive either the PCV (Group PC, n = 20) or VCV (Group VC, n = 20) during laparoscopic cholecystectomy. Blood sampling was made for baseline arterial blood gases (ABG), cortisol, insulin, and glucose levels. General anesthesia with sevoflurane and fentanyl was employed to all patients. After anesthesia induction and endotracheal intubation, patients in Group PC were given pressure support to form 8 mL/kg tidal volume and patients in Group VC was maintained at 8 mL/kg tidal volume calculated using predicted body weight. All patients were maintained with 5 cmH 2 O positive-end expiratory pressure (PEEP). Respiratory parameters were recorded before and 30 min after pneumoperitonium. Assessment of ABG and sampling for cortisol, insulin and glucose levels were repeated 30 min after pneumoperitonium and 60 min after extubation. The P-peak levels observed before (18.9 ± 3.8 versus 15 ± 2.2 cmH 2 O) and during (23.3 ± 3.8 versus 20.1 ± 2.9 cmH 2 O) pneumoperitoneum in Group VC were significantly higher. Postoperative partial arterial oxygen pressure (PaO 2) values are higher (98 ± 12 versus 86 ± 11 mmHg) in Group PC. Arterial carbon dioxide pressure (PaCO 2) values (41.8 ± 5.4 versus 36.7 ± 3.5 mmHg) during pneumoperitonium and post-operative mean cortisol and insulin levels were higher in Group VC. When compared to VCV mode, PCV mode may improve compliance during pneumoperitoneum, improve oxygenation and reduce stress response postoperatively and may be more appropriate in patients having laparoscopic surgery.
Long QT syndrome is an inherited disorder of the heart's electrical activity that may also be... more Long QT syndrome is an inherited disorder of the heart's electrical activity that may also be associated with malignant arrhythmia and cause sudden death. In addition to this inherited condition, several commonly used anesthetic drugs can prolong the QT interval. We present here a 17-month-old male patient who underwent general anesthesia for a cochlear implant. No cardiac arrhythmia was observed in the patient, whose muscle relaxant effect was reversed using sugammadex. The application of intravenous anesthetics was preferred to maintain anesthesia for this patient and was safely applied.
Background Long QT syndrome (LQTS) is an inherited disorder of the heart’s electrical activity th... more Background Long QT syndrome (LQTS) is an inherited disorder of the heart’s electrical activity that may also be associated with malignant arrhythmia and cause sudden death. In addition to this inherited condition, several commonly used anesthetic drugs can prolong the QT interval. The clinical symptoms of LQTS are heart palpitations, syncope, anoxic seizures secondary to ventricular arrhythmia, and torsades de pointes. Case: We present here a 17-month-old male patient with bilateral sensorineural hearing loss who underwent general anesthesia for a cochlear implant. The surgical team was advised about the possible risks of using local anesthesia without adrenaline. A defibrillator, which was checked for pediatric use, was made available in the operating room. After the vascular access was opened, the patient was provided with induction propofol, remifentanil, and rocuronium, and anesthesia was maintained using an intravenous anesthetic. No cardiac arrhythmia was observed in the patie...
Archives of Clinical and Experimental Surgery (ACES), 2016
The intra-abdominal pressure (IAP) exceeding 12 mmHg is called intra-abdominal hypertension (IAH)... more The intra-abdominal pressure (IAP) exceeding 12 mmHg is called intra-abdominal hypertension (IAH) which has deleterious pathophysiological consequences [1,2]. IAH can be encountered in many clinical conditions, such as trauma, retro-/intra-abdominal bleeding, pancreatitis, aggressive fluid resuscitation, intestinal obstruction, tumors and pneumoperitoneum for laparoscopy [1,2]. As it has respiratory, renal, splanchnic, and cerebral complications, much effort has gone in to diagnosis and managing IAH in the last decade. Besides well-known management principles consisting of serial monitoring of IAP, optimization of systemic perfusion and urgent surgical decompression,
Ethical Committee of Clinical Studies (decision number: 21.03). All procedures in this study invo... more Ethical Committee of Clinical Studies (decision number: 21.03). All procedures in this study involving human participants were performed in accordance with the 1964 Helsinki Declaration and its later amendments. Etik Kurul Onayı: Bu çalışma için onay Kırıkkale Üniversitesi Klinik Araştırmalar Etik Kurulu'ndan alınmıştır (karar no: 21.03). İnsan katılımcıların katıldığı çalışmalardaki tüm prosedürler, 1964 Helsinki Deklarasyonu ve daha sonra yapılan değişiklikler uyarınca gerçekleştirilmiştir.
Background Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variety... more Background Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variety of operations on the thorax, abdomen or pelvis. PVB is straightforward, e cacious in operations performed. This study was undertaken to evaluate how e cacious ultrasound-guided thoracic paravertebral block is when used in patients undergoing percutaneous nephrolithotomy (PCN). Methods A total of forty-four patients, falling in categories I to III of the American Society of Anesthesiologists, and aged between 18 and 65 years, who were scheduled for PCN, were randomly distributed into two groups. The anaesthetic intervention group (PVB) contained 22 individuals, who were injected at level T8-T9 with 20 mL 0.25% bupivacaine as a single administration. In the control group C, also containing 22 individuals, the intervention was not carried out. The groups were compared after PCN in terms of opioid use, pain score, opioid adverse effects pro le and the need for supplemental analgesia. Results Visual analogue scale pain scores whilst at rest or moving were lower at the level of statistical signi cance in the PVB group compared to controls at 2 and 4 hours post-surgery. At 6 and 8 hours postsurgery, the control group had a lower VAS score when moving, and this result reached statistical signi cance (p < 0.05). The controls used more opioid relief than the PVB group and had lower scores for satisfaction (p < 0.05). Conclusion Ultrasound-guided PVB using bupivacaine and an in-plane technique provides effective analgesia in PNL. It is associated with high scores on patient satisfaction and minimal complications.
Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, Jan 5, 2016
Marfan Sendromu (MS) 1/5000 oranında otozomal dominant geçiş gösteren bir bağ doku hastalığıdır. ... more Marfan Sendromu (MS) 1/5000 oranında otozomal dominant geçiş gösteren bir bağ doku hastalığıdır. Fibrillin-1 (FBN1) geninin 15q21 kromozomunda mutasyon vardır. İskelet sistemi anormallikleri, lens dislokasyonu, dural ektazi ve aort dilatasyonu ile karakterizedir. Hastaların %80'ninde kardiyovasküler sistemde birtakım değişiklikler mevcut olup bunlar; aort dilatasyonu, aort yetmezliği, mitral-triküspit valv prolapsusu ve regürjitasyonudur. Majör ölüm nedenleri arasında aortik anevrizma rüptürü ve diseksiyonu yer alır. Gebelikteki fizyolojik değişiklikler aort diseksiyonu patogenezi ve progresyonuna katkıda bulunmaktadır. Gebelikte artmış aort kompliyansı ve bunun sonucunda aort dilatasyonu sözkonusudur. Gebelik ve doğum MS'lu hastalarda yaşamı tehdit eden diseksiyonlara yol açar; özellikle de aort çapı 40 mm' den geniş ise. MS'lu gebelerde lumbal spinal deformiteler ve yaygın artrodezisler, epidural ve spinal anestezi başarısızlığını artırır. Benzer şekilde dural ektaziler dural delinme riskinin artmasına neden olur. Bu olgu sunumuyla MS'lu gebe kadında elektif sezaryen operasyonunda genel anestezi uygulamamızı sunmayı amaçladık.
Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, Jan 5, 2016
Nörofibromatozis Tip 1 (NF-1) ektodermal ve mezodermal dokulardaki yaygın etkileri nedeniyle otoz... more Nörofibromatozis Tip 1 (NF-1) ektodermal ve mezodermal dokulardaki yaygın etkileri nedeniyle otozomal dominant geçiş gösteren kalıtsal bir hastalık grubudur. Periferik sinirlerde multipl nörofibromlar ile karakterize olan hastalıkta kutanöz pigmente lekeler (cafe au lait spots) mevcuttur. Bu nörofibromlar sadece sinir sisteminde değil, orofarinks ve larinkste de bulunarak laringoskopiyi ve endotrakeal entübasyonu zorlaştırabilir. Bu olgu sunumuyla NF-1 tanılı gebe kadında elektif sezaryen operasyonunda spinal anestezi uygulamamızı sunmayı amaçladık.
Background and Aims Breast cancer and subsequent breast surgery is prevalent in North America. Ge... more Background and Aims Breast cancer and subsequent breast surgery is prevalent in North America. General anesthesia (GA) is
Background: Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variet... more Background: Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variety of operations on the thorax, abdomen or pelvis. PVB is straightforward, efficacious in operations performed. This study was undertaken to evaluate how efficacious ultrasound-guided thoracic paravertebral block is when used in patients undergoing percutaneous nephrolithotomy (PCN). Methods: A total of 44 patients, falling in categories I to III of the American Society of Anesthesiologists, and aged between 18 and 65 years, who were scheduled for PCN, were randomly distributed into two groups. The anaesthetic intervention group (PVB) contained 22 individuals, who were injected at level T8-T9 with 20 mL 0.25% bupivacaine as a single administration. In the control group C, also containing 22 individuals, the intervention was not carried out. The groups were compared after PCN in terms of opioid use, pain score, opioid adverse effects profile and the need for supplemental analgesia. Results: Visual analogue scale pain scores whilst at rest or moving were lower at the level of statistical significance in the PVB group compared to controls at 2 and 4 h post-surgery. At 6 and 8 h post-surgery, the control group had a lower VAS score when moving, and this result reached statistical significance (p < 0.05). The controls used more opioid relief than the PVB group and had lower scores for satisfaction (p < 0.05). Conclusion: Ultrasound-guided PVB using bupivacaine and an in-plane technique provides effective analgesia in PNL. It is associated with high scores on patient satisfaction and minimal complications. Trial registration: ClinicalTrials.gov, NCT04406012. Registered retrospectively, on 27 May 2020.
Background Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variety... more Background Paravertabral blocks (PVB) are in use to adequately manage pain arising from a variety of operations on the thorax, abdomen or pelvis. PVB is straightforward, e cacious in operations performed. This study was undertaken to evaluate how e cacious ultrasound-guided thoracic paravertebral block is when used in patients undergoing percutaneous nephrolithotomy (PCN). Methods A total of forty-four patients, falling in categories I to III of the American Society of Anesthesiologists, and aged between 18 and 65 years, who were scheduled for PCN, were randomly distributed into two groups. The anaesthetic intervention group (PVB) contained 22 individuals, who were injected at level T8-T9 with 20 mL 0.25% bupivacaine as a single administration. In the control group C, also containing 22 individuals, the intervention was not carried out. The groups were compared after PCN in terms of opioid use, pain score, opioid adverse effects pro le and the need for supplemental analgesia. Results Visual analogue scale pain scores whilst at rest or moving were lower at the level of statistical signi cance in the PVB group compared to controls at 2 and 4 hours post-surgery. At 6 and 8 hours postsurgery, the control group had a lower VAS score when moving, and this result reached statistical signi cance (p < 0.05). The controls used more opioid relief than the PVB group and had lower scores for satisfaction (p < 0.05). Conclusion Ultrasound-guided PVB using bupivacaine and an in-plane technique provides effective analgesia in PNL. It is associated with high scores on patient satisfaction and minimal complications.
Archives of Clinical and Experimental Surgery, 2016
The intra-abdominal pressure (IAP) exceeding 12 mmHg is called intra-abdominal hypertension (IAH)... more The intra-abdominal pressure (IAP) exceeding 12 mmHg is called intra-abdominal hypertension (IAH) which has deleterious pathophysiological consequences [1,2]. IAH can be encountered in many clinical conditions, such as trauma, retro-/intra-abdominal bleeding, pancreatitis, aggressive fluid resuscitation, intestinal obstruction, tumors and pneumoperitoneum for laparoscopy [1,2]. As it has respiratory, renal, splanchnic, and cerebral complications, much effort has gone in to diagnosis and managing IAH in the last decade. Besides well-known management principles consisting of serial monitoring of IAP, optimization of systemic perfusion and urgent surgical decompression,
Introduction: Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are pot... more Introduction: Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are potentially life-threatening conditions in critically ill patients. Laparascopic surgery is the gold standard and has been widely performed for many procedures since its inception in the early 1980s. Pneumoperitoneum is essential for laparascopic surgery. Dexmedetomidine is a potent and highly selective α-2 adrenoceptor agonist with sympatholytic, sedative, amnestic and analgesic properties without respiratory depression. There is increasing evidence of its organ protective effects against ischemic and hypoxic injury, including neuroprotection, cardioprotection and renoprotection. The aim of this experimental study was to investigate the effects of the α-2 adrenoceptor agonist, dexmedetomidine on IAH induced by renal injury. Materials and methods: A total of 24 male Wistar-albino rats were randomly separated into 4 groups as the control group (CG, n=6), sham group (SG, n=6), low-dose group ...
Pressure-controlled ventilation (PCV) is less frequently employed in general anesthesia. With its... more Pressure-controlled ventilation (PCV) is less frequently employed in general anesthesia. With its high and decelerating inspiratory flow, PCV has faster tidal volume delivery and different gas distribution. The same tidal volume setting, delivered by PCV versus volume-controlled ventilation (VCV), will result in a lower peak airway pressure and reduced risk of barotrauma. We hypothesized that PCV instead of VCV during laparoscopic surgery could achieve lower airway pressures and reduce the systemic stress response. Forty ASA I-II patients were randomly selected to receive either the PCV (Group PC, n = 20) or VCV (Group VC, n = 20) during laparoscopic cholecystectomy. Blood sampling was made for baseline arterial blood gases (ABG), cortisol, insulin, and glucose levels. General anesthesia with sevoflurane and fentanyl was employed to all patients. After anesthesia induction and endotracheal intubation, patients in Group PC were given pressure support to form 8 mL/kg tidal volume and patients in Group VC was maintained at 8 mL/kg tidal volume calculated using predicted body weight. All patients were maintained with 5 cmH 2 O positive-end expiratory pressure (PEEP). Respiratory parameters were recorded before and 30 min after pneumoperitonium. Assessment of ABG and sampling for cortisol, insulin and glucose levels were repeated 30 min after pneumoperitonium and 60 min after extubation. The P-peak levels observed before (18.9 ± 3.8 versus 15 ± 2.2 cmH 2 O) and during (23.3 ± 3.8 versus 20.1 ± 2.9 cmH 2 O) pneumoperitoneum in Group VC were significantly higher. Postoperative partial arterial oxygen pressure (PaO 2) values are higher (98 ± 12 versus 86 ± 11 mmHg) in Group PC. Arterial carbon dioxide pressure (PaCO 2) values (41.8 ± 5.4 versus 36.7 ± 3.5 mmHg) during pneumoperitonium and post-operative mean cortisol and insulin levels were higher in Group VC. When compared to VCV mode, PCV mode may improve compliance during pneumoperitoneum, improve oxygenation and reduce stress response postoperatively and may be more appropriate in patients having laparoscopic surgery.
Long QT syndrome is an inherited disorder of the heart's electrical activity that may also be... more Long QT syndrome is an inherited disorder of the heart's electrical activity that may also be associated with malignant arrhythmia and cause sudden death. In addition to this inherited condition, several commonly used anesthetic drugs can prolong the QT interval. We present here a 17-month-old male patient who underwent general anesthesia for a cochlear implant. No cardiac arrhythmia was observed in the patient, whose muscle relaxant effect was reversed using sugammadex. The application of intravenous anesthetics was preferred to maintain anesthesia for this patient and was safely applied.
Background Long QT syndrome (LQTS) is an inherited disorder of the heart’s electrical activity th... more Background Long QT syndrome (LQTS) is an inherited disorder of the heart’s electrical activity that may also be associated with malignant arrhythmia and cause sudden death. In addition to this inherited condition, several commonly used anesthetic drugs can prolong the QT interval. The clinical symptoms of LQTS are heart palpitations, syncope, anoxic seizures secondary to ventricular arrhythmia, and torsades de pointes. Case: We present here a 17-month-old male patient with bilateral sensorineural hearing loss who underwent general anesthesia for a cochlear implant. The surgical team was advised about the possible risks of using local anesthesia without adrenaline. A defibrillator, which was checked for pediatric use, was made available in the operating room. After the vascular access was opened, the patient was provided with induction propofol, remifentanil, and rocuronium, and anesthesia was maintained using an intravenous anesthetic. No cardiac arrhythmia was observed in the patie...
Archives of Clinical and Experimental Surgery (ACES), 2016
The intra-abdominal pressure (IAP) exceeding 12 mmHg is called intra-abdominal hypertension (IAH)... more The intra-abdominal pressure (IAP) exceeding 12 mmHg is called intra-abdominal hypertension (IAH) which has deleterious pathophysiological consequences [1,2]. IAH can be encountered in many clinical conditions, such as trauma, retro-/intra-abdominal bleeding, pancreatitis, aggressive fluid resuscitation, intestinal obstruction, tumors and pneumoperitoneum for laparoscopy [1,2]. As it has respiratory, renal, splanchnic, and cerebral complications, much effort has gone in to diagnosis and managing IAH in the last decade. Besides well-known management principles consisting of serial monitoring of IAP, optimization of systemic perfusion and urgent surgical decompression,
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