Introduction and Aim. There is no consensus on the weight parameters to use when titrating the do... more Introduction and Aim. There is no consensus on the weight parameters to use when titrating the dosage of the neuromuscular blocking agents during intubation. In our study, we administered rocuronium, based on either the lean body weight (LBW) or the total body weight in patients with body mass index (BMI) of 18.5 to 34.9 and compared the duration of action of the drug and its effects on tracheal intubation conditions and hemodynamic parameters. Methods. This is a prospective, observational study. Patients between the ages of 18 and 65 with BMI of 18.5–34.9, who are expected to be under general anesthesia for less than 6 hours, were divided into 3 groups according to their BMI (Group 1 BMI = 18.5–24.9, Group 2 BMI = 25–29.9, Group 3 BMI = 30–34.9). These groups were randomly divided into 2 subgroups: Groups LBW; 1 LBW, 2 LBW, and 3 LBW were given rocuronium intubation dosages based on their LBW while control groups; 1K, 2K, and 3K were given 0.6 mg/kg rocuronium according to their to...
ebelik, kadınlarda fizyolojik değişiklikler kadar psikolojik değişikliklerin de olduğu bir dönemd... more ebelik, kadınlarda fizyolojik değişiklikler kadar psikolojik değişikliklerin de olduğu bir dönemdir. Bunun yanında gebelik öncesi varolan psikiyatrik bozuklukların tekrarlaması veya şiddetlenmesi beklenen bir durumdur. 1,2 Bipolar bozukluğun görülme sıklığı her iki cinsiyette de eşit oranda görülse de, hastalığın kadınların doğurganlık döneminde ortaya çıkması sorunları arttırabilmektedir. Ayrıca gebelik döneminde atakların sık ve şiddetli olduğu da gösterilmiştir. 3 Depresyonun uygun şekilde tedavi edilmemesi, gebenin yetersiz kilo alımı, alkol ve madde kullanımı, erken doğum, düşük doğum ağırlığı, preeklampsi, yetersiz anne-bebek bağlanması gibi problemlere yol açabilir. 4 Bunun yanında bu gebelerde psikotik belirtiler ve intihar riski de artmaktadır. 5 Özellikle gebeliğin erken dönemlerinde uygulanacak ilaç tedavileri fetüste teratojeniteye neden olabilir. Beyin dokusunun elektrik akımıyla uya
Göğüs kalp damar anestezi ve yoğun bakım derneği dergisi, Feb 5, 2013
Histeroskopi, intrauterin patolojilerin tanı ve tedavisinde; hızlı postoperatif derlenme ve düşük... more Histeroskopi, intrauterin patolojilerin tanı ve tedavisinde; hızlı postoperatif derlenme ve düşük morbidite sağlaması nedeni ile "altın standart" bir teknik olarak kabul edilmektedir. Histeroskopi, güvenli ve kolay uygulanabilen minimal invazif bir yöntem olarak kabul edilmesine rağmen, özellikle operatif histeroskopiler anestezistler açısından dikkat edilmesi gereken birçok riski de beraberinde taşımaktadır. Bu olguda, operatif histeroskopi uygulaması sonrasında venöz hava embolisi gelişimini sunarak bu komplikasyonun yönetimine dikkat çekmeyi amaçladık.
İnönü Üniversitesi Turgut Özal Tıp Merkezi dergisi, 2013
Aim: Although acute iron poisoning is more common in the pediatric age, it may be seen at any age... more Aim: Although acute iron poisoning is more common in the pediatric age, it may be seen at any age and is an important clinical condition. In this study, we aimed to evaluate the etiological factors and diagnosis and discuss treatment approaches in the acute iron poisoning. Material and Methods: Eight patients who were admitted to the intensive care unit due to acute iron poisoning were analyzed. Data regarding demographic features, cause of poisoning, toxic agents, the route of exposure, a history of previous toxicity, the time between exposure and intensive care unit admission, the owner of the poisoning agent (the patient or someone else), consciousness status on arrival, Glasgow coma score, the length of the intensive care unit stay, the result of laboratory tests, methods of treatment, and outcome were evaluated. Results: All 8 patients were female and the mean age was 22p5,4 years. The most common symptoms were abdominal pain, vomiting and diarrhea. The amount of received elemental iron was 30,25p11,4mg/kg. Nasogastric catheters were inserted and gastric lavages were performed to all the patients in the emergency department. Deferoxamine treatment was not implemented because of serum iron levels were not higher than 500 mg / dL. After observing all patients for two days, one patient was transferred to psychiatric clinic, 7 patients were discharged with full recovery. Conclusions: In potentially fatal acute iron poisoning, serious complications can be avoided with early laboratory and clinical follow-up. The basic supportive therapy with gastric lavage and desferroksamine therapy should be managed on time. Key words: Acute Iron Poisoning; Intensive are; Deferoxamine.
The study aim was to compare the efficacy of dexmedetomidine vs midazolam for sedation during the... more The study aim was to compare the efficacy of dexmedetomidine vs midazolam for sedation during the early postoperative period in adolescents who underwent scoliosis surgery. We performed a prospective, randomized trial in an intensive care unit (ICU) in a tertiary care center. In this study, 42 patients (American Society of Anesthesiology physical status I and II) who underwent scoliosis surgery were divided into two groups according to sedation protocols: group dexmedetomidine (DEX) (n = 22) and group midazolam (MDZ) (n = 20). Adolescents (12-18 years) requiring mechanical ventilation underwent a continuous infusion of either dexmedetomidine (group DEX; starting dose, 0.4 μg·kg(-1) ·h(-1)) or midazolam (group MDZ; starting dose, 0.1 mg·kg(-1) ·h(-1)) with intermittent fentanyl, as needed. The efficacy of sedation was assessed using the Richmond Agitation Sedation Scale (RASS). Quality of pain relief was measured using the Numeric Visual Analog Scale (NVAS). Delirium was determined in patients in the RASS range of -2 to +1 using the Confusion Assessment Method for the ICU (CAM-ICU). Fentanyl consumption, incidence of delirium, NVAS scores, and hemodynamics were recorded postoperatively at 2, 4, 6, and 24 h in the ICU. The NVAS pain scores and fentanyl consumption at all the evaluation time points were significantly higher in group MDZ than those in group DEX (P < 0.05). Further, total fentanyl consumption in group MDZ was significantly higher than that in group DEX (P < 0.05). Delirium was significantly higher in the group MDZ than that in group DEX (31.3% vs 12.5%) when analyzed as the endpoint of CAM-ICU (P < 0.05). The heart rate was significantly lower in group DEX compared with that in group MDZ at all the evaluation time points (P < 0.05). Dexmedetomidine was associated with the decreased postoperative fentanyl consumption, NVAS scores, and a decreased incidence of delirium. These findings may be beneficial for managing sedation protocols in adolescents who have undergone scoliosis surgery.
Background: Transversus Abdominis Plane (TAP) block produces more effective postoperative analges... more Background: Transversus Abdominis Plane (TAP) block produces more effective postoperative analgesia and significantly reduces consumption of postoperative opioids after various abdominal surgeries. It can be performed either preoperatively or postoperatively. Furthermore studies investigating the ideal period for TAP block administration are few. The objective of our study was to investigate, which period is more effective for administration of TAP block on postoperative analgesia in patients undergoing total abdominal hysterectomy. Methods: This prospective randomized controlled double-blind study was conducted with 60 patients between the ages of 18-65 and ASA class I-II who were scheduled to undergo total abdominal hysterectomy. Patients who received a TAP block with ultrasound guidance prior to the surgical procedure were referred to as Group 1, the TAP block procedure after surgery made up Group 2. The rest and movement period Visual Analog Score (VAS), sedation score, nausea, ...
BackgroundThis study were designed to investigate the usefulness of the videolaryngoscope-guided ... more BackgroundThis study were designed to investigate the usefulness of the videolaryngoscope-guided insertion technique compared with the standard digital technique for the insertion success rate and insertion conditions of the Proseal™ laryngeal mask airway (PLMA).MethodsProspective, one hundred and nineteen patients (ASA I–II, aged 18–65 yr) were randomly divided for PLMA insertion using the videolaryngoscope-guided technique or the standard digital technique. The PLMA was inserted according to the manufacturer’s instructions in the standard digital technique group. The videolaryngoscope-guided technique was performed a C-MAC® videolaryngoscope with D-Blade, under gentle videolaryngoscope guidance, the epiglottis was lifted, and the PLMA was advanced until the tip of the distal cuff reached the oesophagus inlet. The number of insertion attempts, insertion time, oropharyngeal leak pressure, leak volume, fiberoptic bronchoscopic view, peak inspiratory pressure, ease of gastric tube pla...
Our hypothesis was that intubations with the McGRATH MAC videolaryngoscope in elderly patients wo... more Our hypothesis was that intubations with the McGRATH MAC videolaryngoscope in elderly patients would produce less hemodynamic responses and ECG changes than the Macintosh direct laryngoscope. The patients were divided into two groups: patients who were intubated using the McGRATH MAC (Group V, n = 45) and patients who were intubated using the Macintosh direct laryngoscope (Group L, n = 45). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP), heart rate (HR) were recorded before induction with anesthesia (baseline), immediately after induction and at 1 min, 3 min, and 5 min after intubation, with simultaneous ECG. When Group L was compared to Group V, there was an increase in the first, third and fitth minutes after intubation in terms of HR. SBP, MAP increased only at 1 min after intubation and DBP increased in the first and third minutes after intubation in Group L. In Group L, there was a significant difference in the HR values immedi...
Medicine Science | International Medical Journal, 2016
Tracheal intubation using direct laryngoscopy has become an essential part in the anesthesia mana... more Tracheal intubation using direct laryngoscopy has become an essential part in the anesthesia management of the surgical patient. Big oropharynx mass can cause serious problems depending on their locations. Mass lesions of oropharynx may lead to difficult intubation. In this letter, we present a successful application of airway management with general anesthesia in a neonatal patient with big oropharynx mass.
Medicine Science | International Medical Journal, 2016
Polyneuropathy that characterized by diffuse axonal degeneration or multifocal segmental demyelin... more Polyneuropathy that characterized by diffuse axonal degeneration or multifocal segmental demyelination is neuropathy and usually influence peripheral nerves. It can lead to respiratory failure with muscle weakness, atrophy, fasciculations, and the involvement of the respiratory muscles. Increased risk of malignant hyperthermia, potential airway problems that may develop after extubation with effected the respiratory muscles, prolonged duration of recovery from non-depolarizing neuromuscular blockade, the discussion of the used neuraxial anesthesia makes anesthesia management important in patient with polyneuropathy. In this presentation aimed to provide general anesthesia management without neuromuscular blockade a patient with motor-sensory polyneuropathy mainly demyelinating who underwent posterior instrumentation due to scoliosis.
Poisoning is an important cause of admission to intensive care units (ICUs) and prolongs the leng... more Poisoning is an important cause of admission to intensive care units (ICUs) and prolongs the length of stay (LOS) in the ICU. The patients whose admitted to the ICU with poisoning may require mechanical ventilation (MV). The need of prolonged MV causes a significantly longer LOS and higher mortality in the ICU. The analysis of the characteristics and outcomes of patients receiving MV after poisoning may be useful in the clinical management of these patients, allowing for better counseling of the patients and their families. The objective of this retrospective study to evaluate the relationship between demographic and etiological characteristics with need of MV in patients admitted to ICU due to poisoning. Material and Method: 211 patients diagnosed with poisoning were analyzed from January 2010 to December 2011. Data regarding age, gender, the time between exposure and ICU admission, type of poisoning, exposure to toxic agents, the route of exposure, a history of previous toxicity, consciousness status on arrival, the length of the ICU stay, need of MV, complications associated with MV, the Glasgow coma scale and outcome were obtained. Results: Of the 211 patients, 143 (67.8%) were female. The most common cause of poisoning was suicide (87.7%), and the main route of exposure was oral (93.4%). The greatest number of agents which patients were exposed was drugs. (74.4%). The most common drugs causing poisoning were antidepressants (including tricyclic antidepressants) (38.3%). The need of MV was significantly related to both gender (p=0.04) and the route of exposure (p<0.001). The need of MV was also significantly related to type of poisoning (p=0.01) and the toxic agents (p<0.001).There were very strong relationships between the drug poisoning and gender (p=0.002) and between type of poisoning and gender (p=0.006). Conclusion: The present study demonstrated that there were significant relationships between the need of MV and gender, type of poisoning, the toxic agents, the route of exposure and the ICU LOS. The need of MV may lead to poor outcome as it is associated with higher incidence of ventilator related complications and longer ICU stay.
This is case of a non-invasive ventilation treatment of severe asthma with acute cardiogenic pulm... more This is case of a non-invasive ventilation treatment of severe asthma with acute cardiogenic pulmonary edema, who underwent transurethral resection of the prostate under subarachnoid anesthesia. There is no sufficient data in literature about the occurence of non-invasive ventilation after severe asthma. We believed it is important to call attention to this unusual treatment. Key words: Asthma; Acute Cardiogenic Pulmonary Edema; Non-invasive Mechanical Ventilation.
The aim of this study was to determine whether pretreatment with alkalinised lignocaine reduced t... more The aim of this study was to determine whether pretreatment with alkalinised lignocaine reduced the incidence and severity of pain during propofol injection. This prospective, randomised, double-blind study included 300 adult, American Society of Anesthesiologists physcial status I to II patients undergoing elective surgery. Patients were randomly allocated to one of three groups: group l received 0.05 ml/kg of 1% lignocaine (5 ml normal saline + 5 ml 2% lignocaine), group A received 0.05 ml/kg alkalinised lignocaine (5 ml 2% lignocaine + 1 ml 8.4% NaHCO 3 + 4 ml normal saline), and group S, the control group, was given the same amount of normal saline (NaCl 0.9%). All drugs were given as a bolus over 20 seconds before propofol administration. A blinded researcher assessed the patient's pain level using a four-point scale. The pain score [median (range)] and the incidence of pain in group A (6%) was significantly lower than in groups l (41%) and S (88%, P <0.001). In addition, the pain score and the incidence of pain were found to be significantly different between group l and group S (P <0.001). The incidence of moderate and severe pain were greater in group S when compared with groups A and l (P <0.001). Intravenous pretreatment with alkalinised lignocaine appears to be effective in reducing the pain during propofol injection.
Introduction and Aim. There is no consensus on the weight parameters to use when titrating the do... more Introduction and Aim. There is no consensus on the weight parameters to use when titrating the dosage of the neuromuscular blocking agents during intubation. In our study, we administered rocuronium, based on either the lean body weight (LBW) or the total body weight in patients with body mass index (BMI) of 18.5 to 34.9 and compared the duration of action of the drug and its effects on tracheal intubation conditions and hemodynamic parameters. Methods. This is a prospective, observational study. Patients between the ages of 18 and 65 with BMI of 18.5–34.9, who are expected to be under general anesthesia for less than 6 hours, were divided into 3 groups according to their BMI (Group 1 BMI = 18.5–24.9, Group 2 BMI = 25–29.9, Group 3 BMI = 30–34.9). These groups were randomly divided into 2 subgroups: Groups LBW; 1 LBW, 2 LBW, and 3 LBW were given rocuronium intubation dosages based on their LBW while control groups; 1K, 2K, and 3K were given 0.6 mg/kg rocuronium according to their to...
ebelik, kadınlarda fizyolojik değişiklikler kadar psikolojik değişikliklerin de olduğu bir dönemd... more ebelik, kadınlarda fizyolojik değişiklikler kadar psikolojik değişikliklerin de olduğu bir dönemdir. Bunun yanında gebelik öncesi varolan psikiyatrik bozuklukların tekrarlaması veya şiddetlenmesi beklenen bir durumdur. 1,2 Bipolar bozukluğun görülme sıklığı her iki cinsiyette de eşit oranda görülse de, hastalığın kadınların doğurganlık döneminde ortaya çıkması sorunları arttırabilmektedir. Ayrıca gebelik döneminde atakların sık ve şiddetli olduğu da gösterilmiştir. 3 Depresyonun uygun şekilde tedavi edilmemesi, gebenin yetersiz kilo alımı, alkol ve madde kullanımı, erken doğum, düşük doğum ağırlığı, preeklampsi, yetersiz anne-bebek bağlanması gibi problemlere yol açabilir. 4 Bunun yanında bu gebelerde psikotik belirtiler ve intihar riski de artmaktadır. 5 Özellikle gebeliğin erken dönemlerinde uygulanacak ilaç tedavileri fetüste teratojeniteye neden olabilir. Beyin dokusunun elektrik akımıyla uya
Göğüs kalp damar anestezi ve yoğun bakım derneği dergisi, Feb 5, 2013
Histeroskopi, intrauterin patolojilerin tanı ve tedavisinde; hızlı postoperatif derlenme ve düşük... more Histeroskopi, intrauterin patolojilerin tanı ve tedavisinde; hızlı postoperatif derlenme ve düşük morbidite sağlaması nedeni ile "altın standart" bir teknik olarak kabul edilmektedir. Histeroskopi, güvenli ve kolay uygulanabilen minimal invazif bir yöntem olarak kabul edilmesine rağmen, özellikle operatif histeroskopiler anestezistler açısından dikkat edilmesi gereken birçok riski de beraberinde taşımaktadır. Bu olguda, operatif histeroskopi uygulaması sonrasında venöz hava embolisi gelişimini sunarak bu komplikasyonun yönetimine dikkat çekmeyi amaçladık.
İnönü Üniversitesi Turgut Özal Tıp Merkezi dergisi, 2013
Aim: Although acute iron poisoning is more common in the pediatric age, it may be seen at any age... more Aim: Although acute iron poisoning is more common in the pediatric age, it may be seen at any age and is an important clinical condition. In this study, we aimed to evaluate the etiological factors and diagnosis and discuss treatment approaches in the acute iron poisoning. Material and Methods: Eight patients who were admitted to the intensive care unit due to acute iron poisoning were analyzed. Data regarding demographic features, cause of poisoning, toxic agents, the route of exposure, a history of previous toxicity, the time between exposure and intensive care unit admission, the owner of the poisoning agent (the patient or someone else), consciousness status on arrival, Glasgow coma score, the length of the intensive care unit stay, the result of laboratory tests, methods of treatment, and outcome were evaluated. Results: All 8 patients were female and the mean age was 22p5,4 years. The most common symptoms were abdominal pain, vomiting and diarrhea. The amount of received elemental iron was 30,25p11,4mg/kg. Nasogastric catheters were inserted and gastric lavages were performed to all the patients in the emergency department. Deferoxamine treatment was not implemented because of serum iron levels were not higher than 500 mg / dL. After observing all patients for two days, one patient was transferred to psychiatric clinic, 7 patients were discharged with full recovery. Conclusions: In potentially fatal acute iron poisoning, serious complications can be avoided with early laboratory and clinical follow-up. The basic supportive therapy with gastric lavage and desferroksamine therapy should be managed on time. Key words: Acute Iron Poisoning; Intensive are; Deferoxamine.
The study aim was to compare the efficacy of dexmedetomidine vs midazolam for sedation during the... more The study aim was to compare the efficacy of dexmedetomidine vs midazolam for sedation during the early postoperative period in adolescents who underwent scoliosis surgery. We performed a prospective, randomized trial in an intensive care unit (ICU) in a tertiary care center. In this study, 42 patients (American Society of Anesthesiology physical status I and II) who underwent scoliosis surgery were divided into two groups according to sedation protocols: group dexmedetomidine (DEX) (n = 22) and group midazolam (MDZ) (n = 20). Adolescents (12-18 years) requiring mechanical ventilation underwent a continuous infusion of either dexmedetomidine (group DEX; starting dose, 0.4 μg·kg(-1) ·h(-1)) or midazolam (group MDZ; starting dose, 0.1 mg·kg(-1) ·h(-1)) with intermittent fentanyl, as needed. The efficacy of sedation was assessed using the Richmond Agitation Sedation Scale (RASS). Quality of pain relief was measured using the Numeric Visual Analog Scale (NVAS). Delirium was determined in patients in the RASS range of -2 to +1 using the Confusion Assessment Method for the ICU (CAM-ICU). Fentanyl consumption, incidence of delirium, NVAS scores, and hemodynamics were recorded postoperatively at 2, 4, 6, and 24 h in the ICU. The NVAS pain scores and fentanyl consumption at all the evaluation time points were significantly higher in group MDZ than those in group DEX (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Further, total fentanyl consumption in group MDZ was significantly higher than that in group DEX (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Delirium was significantly higher in the group MDZ than that in group DEX (31.3% vs 12.5%) when analyzed as the endpoint of CAM-ICU (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). The heart rate was significantly lower in group DEX compared with that in group MDZ at all the evaluation time points (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Dexmedetomidine was associated with the decreased postoperative fentanyl consumption, NVAS scores, and a decreased incidence of delirium. These findings may be beneficial for managing sedation protocols in adolescents who have undergone scoliosis surgery.
Background: Transversus Abdominis Plane (TAP) block produces more effective postoperative analges... more Background: Transversus Abdominis Plane (TAP) block produces more effective postoperative analgesia and significantly reduces consumption of postoperative opioids after various abdominal surgeries. It can be performed either preoperatively or postoperatively. Furthermore studies investigating the ideal period for TAP block administration are few. The objective of our study was to investigate, which period is more effective for administration of TAP block on postoperative analgesia in patients undergoing total abdominal hysterectomy. Methods: This prospective randomized controlled double-blind study was conducted with 60 patients between the ages of 18-65 and ASA class I-II who were scheduled to undergo total abdominal hysterectomy. Patients who received a TAP block with ultrasound guidance prior to the surgical procedure were referred to as Group 1, the TAP block procedure after surgery made up Group 2. The rest and movement period Visual Analog Score (VAS), sedation score, nausea, ...
BackgroundThis study were designed to investigate the usefulness of the videolaryngoscope-guided ... more BackgroundThis study were designed to investigate the usefulness of the videolaryngoscope-guided insertion technique compared with the standard digital technique for the insertion success rate and insertion conditions of the Proseal™ laryngeal mask airway (PLMA).MethodsProspective, one hundred and nineteen patients (ASA I–II, aged 18–65 yr) were randomly divided for PLMA insertion using the videolaryngoscope-guided technique or the standard digital technique. The PLMA was inserted according to the manufacturer’s instructions in the standard digital technique group. The videolaryngoscope-guided technique was performed a C-MAC® videolaryngoscope with D-Blade, under gentle videolaryngoscope guidance, the epiglottis was lifted, and the PLMA was advanced until the tip of the distal cuff reached the oesophagus inlet. The number of insertion attempts, insertion time, oropharyngeal leak pressure, leak volume, fiberoptic bronchoscopic view, peak inspiratory pressure, ease of gastric tube pla...
Our hypothesis was that intubations with the McGRATH MAC videolaryngoscope in elderly patients wo... more Our hypothesis was that intubations with the McGRATH MAC videolaryngoscope in elderly patients would produce less hemodynamic responses and ECG changes than the Macintosh direct laryngoscope. The patients were divided into two groups: patients who were intubated using the McGRATH MAC (Group V, n = 45) and patients who were intubated using the Macintosh direct laryngoscope (Group L, n = 45). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP), heart rate (HR) were recorded before induction with anesthesia (baseline), immediately after induction and at 1 min, 3 min, and 5 min after intubation, with simultaneous ECG. When Group L was compared to Group V, there was an increase in the first, third and fitth minutes after intubation in terms of HR. SBP, MAP increased only at 1 min after intubation and DBP increased in the first and third minutes after intubation in Group L. In Group L, there was a significant difference in the HR values immedi...
Medicine Science | International Medical Journal, 2016
Tracheal intubation using direct laryngoscopy has become an essential part in the anesthesia mana... more Tracheal intubation using direct laryngoscopy has become an essential part in the anesthesia management of the surgical patient. Big oropharynx mass can cause serious problems depending on their locations. Mass lesions of oropharynx may lead to difficult intubation. In this letter, we present a successful application of airway management with general anesthesia in a neonatal patient with big oropharynx mass.
Medicine Science | International Medical Journal, 2016
Polyneuropathy that characterized by diffuse axonal degeneration or multifocal segmental demyelin... more Polyneuropathy that characterized by diffuse axonal degeneration or multifocal segmental demyelination is neuropathy and usually influence peripheral nerves. It can lead to respiratory failure with muscle weakness, atrophy, fasciculations, and the involvement of the respiratory muscles. Increased risk of malignant hyperthermia, potential airway problems that may develop after extubation with effected the respiratory muscles, prolonged duration of recovery from non-depolarizing neuromuscular blockade, the discussion of the used neuraxial anesthesia makes anesthesia management important in patient with polyneuropathy. In this presentation aimed to provide general anesthesia management without neuromuscular blockade a patient with motor-sensory polyneuropathy mainly demyelinating who underwent posterior instrumentation due to scoliosis.
Poisoning is an important cause of admission to intensive care units (ICUs) and prolongs the leng... more Poisoning is an important cause of admission to intensive care units (ICUs) and prolongs the length of stay (LOS) in the ICU. The patients whose admitted to the ICU with poisoning may require mechanical ventilation (MV). The need of prolonged MV causes a significantly longer LOS and higher mortality in the ICU. The analysis of the characteristics and outcomes of patients receiving MV after poisoning may be useful in the clinical management of these patients, allowing for better counseling of the patients and their families. The objective of this retrospective study to evaluate the relationship between demographic and etiological characteristics with need of MV in patients admitted to ICU due to poisoning. Material and Method: 211 patients diagnosed with poisoning were analyzed from January 2010 to December 2011. Data regarding age, gender, the time between exposure and ICU admission, type of poisoning, exposure to toxic agents, the route of exposure, a history of previous toxicity, consciousness status on arrival, the length of the ICU stay, need of MV, complications associated with MV, the Glasgow coma scale and outcome were obtained. Results: Of the 211 patients, 143 (67.8%) were female. The most common cause of poisoning was suicide (87.7%), and the main route of exposure was oral (93.4%). The greatest number of agents which patients were exposed was drugs. (74.4%). The most common drugs causing poisoning were antidepressants (including tricyclic antidepressants) (38.3%). The need of MV was significantly related to both gender (p=0.04) and the route of exposure (p<0.001). The need of MV was also significantly related to type of poisoning (p=0.01) and the toxic agents (p<0.001).There were very strong relationships between the drug poisoning and gender (p=0.002) and between type of poisoning and gender (p=0.006). Conclusion: The present study demonstrated that there were significant relationships between the need of MV and gender, type of poisoning, the toxic agents, the route of exposure and the ICU LOS. The need of MV may lead to poor outcome as it is associated with higher incidence of ventilator related complications and longer ICU stay.
This is case of a non-invasive ventilation treatment of severe asthma with acute cardiogenic pulm... more This is case of a non-invasive ventilation treatment of severe asthma with acute cardiogenic pulmonary edema, who underwent transurethral resection of the prostate under subarachnoid anesthesia. There is no sufficient data in literature about the occurence of non-invasive ventilation after severe asthma. We believed it is important to call attention to this unusual treatment. Key words: Asthma; Acute Cardiogenic Pulmonary Edema; Non-invasive Mechanical Ventilation.
The aim of this study was to determine whether pretreatment with alkalinised lignocaine reduced t... more The aim of this study was to determine whether pretreatment with alkalinised lignocaine reduced the incidence and severity of pain during propofol injection. This prospective, randomised, double-blind study included 300 adult, American Society of Anesthesiologists physcial status I to II patients undergoing elective surgery. Patients were randomly allocated to one of three groups: group l received 0.05 ml/kg of 1% lignocaine (5 ml normal saline + 5 ml 2% lignocaine), group A received 0.05 ml/kg alkalinised lignocaine (5 ml 2% lignocaine + 1 ml 8.4% NaHCO 3 + 4 ml normal saline), and group S, the control group, was given the same amount of normal saline (NaCl 0.9%). All drugs were given as a bolus over 20 seconds before propofol administration. A blinded researcher assessed the patient's pain level using a four-point scale. The pain score [median (range)] and the incidence of pain in group A (6%) was significantly lower than in groups l (41%) and S (88%, P <0.001). In addition, the pain score and the incidence of pain were found to be significantly different between group l and group S (P <0.001). The incidence of moderate and severe pain were greater in group S when compared with groups A and l (P <0.001). Intravenous pretreatment with alkalinised lignocaine appears to be effective in reducing the pain during propofol injection.
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Papers by Mehmet Erdogan